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August 17, 2000

Research: Cure

Question from the Netherlands:

Recently, a research team in the Netherlands published results of what they called a possible cure of diabetes. They found out that when a person has a kidney and pancreas transplant, they were cured of diabetes. This was partly due to a medicine they got before the transplantation which kills the whole immune defense system. The body creates than a new defense system which might not kill the pancreas again. They gave this "medicine" to diabetes patients and gave them only a pancreas transplantation. In most cases, the results were positive because the new defense system does not have "the mistake" which was formerly responsible for diabetes. The theory is: kill the current defense system with its "mistake" and let the body create a new defense system with probably no mistake in it. Are you familiar with these results? What is your opinion?

Answer:

Most pancreas transplants so far have been in conjunction with Kidney transplants and in some centers around the world the one year survival of the grafts is greater than 98%. Pancreas transplant alone (PTA) can now be carried out with similar success so that it has become a consideration for the long term management of diabetics without chronic renal complications. This greatly improved success seems to have been due to advances in immunosuppressive therapy with the inclusion of drugs like mycophenolate mofetil (MMF) and tacrolimus. Unfortunately these improvements have not yet extended to islet cell transplantation although there are hopes for encapsulated porcine islets. If you were interested in further details you might search under ‘mycophenolate mofetil and pancreas transplantation at PubMed.

DOB