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April 22, 2003

Transplants

Question from Phoenix, Arizona, USA:

Why can't islet cells be taken from my pancreas and transplanted into my son? How do I apply for my son to participate in an islet cell transplant clinical trial?

Answer:

The Edmonton group made a dramatic contribution to islet cell transplantation, but it still requires from two to four donors for the recipient to become insulin independent. In addition, there has to be a commitment to a lifetime of immunosuppression. For these reasons, I don’t think that your son would be accepted as a transplant candidate.

Having said all this, you should know that research groups are making steady progress in developing surrogate insulin producing cells and in minimising the process of achieving graft tolerance. Although any practical application is still many years away, it has been shown for instance that a person’s own bone marrow stem cells can be induced to produce insulin, donor islet cells can have an additional insulin gene implanted to increase there effectiveness, and as the process of pancreas regeneration is increasingly understood, it even seems possible that a subjects own mature cells may be induced by ‘transcription’ factors to substitute for islet cells.

DOB

[Editor’s comment: The New Yorker magazine occasionally has articles in a series called “Annals of Medicine.” The February 10, 2003 issue has an in-depth discussion of islet cell transplantation. (The article is available on-line at http://www.isletservice.org/articles/ed.htm.)

SS]