Islet transplants: A cure for diabetes?
Emory has achieved a number of transplant firsts, including Georgia’s first transplant of a kidney (1966), heart (1985), liver (1987), kidney-pancreas (1989), and lung (1993). Most recently, Emory performed Georgia’s first islet transplant—a treatment that can eliminate the need for insulin in Type I diabetics.
Emory has the only islet transplant program in the state, and the Clinical Islet Lab is one of a handful of such centers in the world. To date, eight islet transplants have been performed at Emory. The procedure involves harvesting islet cells—pancreatic cells that produce insulin and regulate blood sugar levels—from a cadaver and injecting them into the recipient’s liver.
Following the transplant, patients must take immunosuppressive drugs to keep their bodies from rejecting the new islets and to block recurrence of diabetes.
“The staff at the Emory transplant center are indeed miracle workers,” says Laura Cochran, of Columbus, Georgia, who suffered from Type I diabetes for more than seventeen years and received an islet cell transplant in May 2004.
After the transplant, she went from being dependant on an insulin pump to needing only small amounts of insulin. “Because of Emory, I feel like I have my life back,” she says.
More than one million Americans have Type 1 diabetes (previously known as juvenile diabetes); thirteen thousand of these are children. In Type 1 diabetes, islets in the pancreas are permanently destroyed by the body’s immune system. People with the disease require several injections of insulin each day, and must follow a strict diet and monitor their blood glucose levels. They are at increased risk for stroke, heart attack, kidney failure, amputation, blindness, and premature death.
Surgeon Christian P. Larsen 80C 84M (left), Carlos and Marguerite Mason Professor of Surgery in Transplantation Biology and director of the Emory Transplant Center, says in its first few years, Emory’s islet-transplant program fielded more than five thousand inquiries from patients, but that—like all transplant programs—the number of islet transplants that can be done depends on finding matching donors.
The first attempt to transplant islet cells in humans was in 1982. Experimental trials continued into the 1990s but success rates remained under 10 percent. In 2001, researchers at the University of Alberta in Edmonton fine-tuned the technique and vastly improved the success rate.
“They made a gutsy move,” says Professor of Surgery Collin Weber. “We are all standing on their shoulders. The main advance was the purification of the islets themselves.”
Emory’s clinical islet lab opened in 2002 and received FDA approval in 2003. The first transplant was performed on Wendy Kenny, a forty-two-year-old pharmacist from Covington, who was then taken off insulin for the first time since she was nine.
The Juvenile Diabetes Research Foundation recently gave Emory’s Center for Islet Transplantation $8.5 million to continue their work on advancing islet transplantation to a mainstream therapy.—M.J.L.