Pancreas Cell Transplant May Forever Change Diabetic Care

A Houston woman dependent on insulin since childhood is producing it on her own, four days after undergoing an experimental cell transplant for severe diabetes.

The promising procedure, which includes the transplant of islet cells taken from a donor pancreas, is being studied in a clinical trial at Baylor College of Medicine and The Methodist Hospital, in collaboration with the Diabetes Research Institute at the University of Miami.

The Jan. 17 transplant was the first performed in Texas. Within 24 hours, doctors determined the transplanted cells were already starting to produce insulin.

Jeanne Weido, 36, was first diagnosed with diabetes at age 7. She has been managing her diabetes through multiple daily injections or pump delivery of insulin ever since.

"To think of my life without diabetes is almost unimaginable," she said. "I could finally have freedom from this disease that has controlled my life."

During the transplant she received 395,000 islet cells from the donor pancreas.

"The initial glucose levels look good," said Dr. John Goss, associate professor of surgery at Baylor and liver transplant surgeon at The Methodist Hospital. "Though we cannot say yet that her diabetes will be cured, we are optimistic about the possibility."

Type 1 insulin-dependent diabetes affects more than 1 million people in the United States. Patients can suffer multiple complications, including life-threatening and disabling conditions.

Weido qualified for the study after undergoing a series of screening tests. She had been on the waiting list for islet transplant since September.

"I feel honored to be a part of this important research," Weido said. "It’s very exciting to think that I am contributing to something that might one day help a child who would otherwise face a lifetime of total dependence on insulin."

In the simple procedure, performed by Dr. George Soltes, an interventional radiologist, insulin-producing cells taken from a donor pancreas were placed directly into the patient’s liver through an injection. In this study, the liver serves as a host for the transplanted cells.

"This procedure may lead to a significant improvement in the care of patients with diabetes," said Goss. "It’s an alternative to a whole pancreas transplant, which carries a number of risks."

A pancreas transplant is major surgery, usually associated with a lengthy hospital stay, a long recovery and a high risk for rejection.

In the Baylor-Methodist study, 24 patients can be enrolled over two years. Those considered must have type 1 diabetes for more than five years,

be evaluated as having a severe case of diabetes, have ideal body weight and no secondary complications.

Patients who receive the transplants must take anti-rejection medications for life. A second transplant may be required for patients undergoing this experimental procedure.

Dr. F. Charles Brunicardi, chairman of the Michael E. DeBakey department of surgery at Baylor and chief of surgery at Methodist, has been involved in islet transplant research for more than a decade. Human trials were conducted in the early 1990s, but results were not encouraging. The development of new anti-rejection drugs, reported by researchers in Canada last summer, was considered a major advance in the transplant research.

"It’s exciting to transplant our first patient in this important research study," Dr. Brunicardi said. "We cannot know how effective this procedure will eventually be until we follow these first participants, but we are very encouraged by the results seen in patients at other institutions."

The collaboration between Methodist, Baylor and the Diabetes Research Institute is a first in islet cell transplantation. The Diabetes Research Institute has been transplanting islet cells for three years.

"It is, in fact, of major importance that we have been the first to demonstrate that islets processed at one center can be safely preserved, transported and transplanted at another institution across the country," said Dr. Camillo Ricordi, scientific director at the Diabetes Research Institute.

For more information, access http://www.methodisthealth.com or http://www.bcm.tmc.edu/pa.

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©2006 Texas Medical Center

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