My 68 year old mother has had diabetes for 18 years.. At first she controlled her diabetes with diet, but, for the past five years, she has needed to take insulin twice a day. She has had a heart attack, bypass surgery, and this past week she had another slight heart attack. They did a heart catheterization yesterday and found one artery blocked, but a major artery still looks good so she will not have to have surgery. They will increase her diuretic medication to pull off fluids in her lungs. She had a new eye lens implant about a year ago, but the damage from the diabetes has already been done.

Where or who would do a pancreas implant for us? I do not have diabetes, and I am quite willing to give her a piece of my good pancreas in order to cure this condition. Do you have any information on this procedure?

It would seem most likely that your mother must have type�2 diabetes, a condition in which the primary problem is resistance to the action of insulin rather than the loss of the insulin producing cells in the pancreas. It is true of course that in trying to overcome this resistance the islets may ultimately become exhausted and insulin supplements are then required. This has an important bearing though on transplantation.

In type�1, immunoregulatory drugs can suppress both the autoimmune problem and the normal rejection phenomenon, but in type 2, the insulin resistance remains. Whole pancreas transplantation has become very successful with graft survival of over 95%; but, for the above reasons, it is primarily limited to type 1 cases.The same rationale applies to islet cell transplants which now promise to be even more successful. So you can see, perhaps, why your generous offer of a segment of your own pancreas, even though it would get around the shortage of cadaver organs, would still be unlikely to work. On top of all these negatives the operation, though, it was tried some years ago was not successful.

Even so I think that you should either ask your mother’s doctor for the name of one of the transplant team at Emory University in Atlanta or if he/she can’t help, then just call the Department of Surgery and track down a name to write to. In the meantime I think that it might really help your mother to get help in making a major effort to improve her blood sugar control.

DOB