Results mixed for diabetic transplants

A treatment developed in Alberta has ended insulin dependence for dozens of Canadians but has been less successful outside the country, researchers say.

The technique, known as the Edmonton Protocol, involves extracting insulin-producing islet cells from a donor pancreas and injecting them into people with diabetes.

Diabetics who have trouble controlling their blood glucose levels with insulin injections, diet and exercise are eligible for the transplant. Three years ago, then-U.S. President Bill Clinton offered $5 million to try the procedure in six American and three European sites.

Dr. James Shapiro, who led the University of Alberta team who developed the procedure, said at the three lead centres in Edmonton, Miami and Minnesota, 90 per cent of patients are now insulin free.

Before the transplant, Gail Thorburn couldn't work or drive a car.

"I feel like I'm normal," Thorburn said. "My husband wants Dr. Shapiro to install an off switch so he can turn me off, because I'm just go, go, go. I'm just very excited and happy. It's great to be alive."

At the other centres, 23 per cent of patients were able to become insulin free. For six patients, the initial transplants did not work.

Shapiro isn't disappointed, saying the trial had a small sample of 36 patients enrolled. He said the results show the difficulty of extracting healthy islet cells from donated organs.

The procedure is "not very efficient and we need some better processes for getting more islets from the pancreas," Shapiro said. "We need that to be more reliable."

Dozens of other centres are adapting the Edmonton Protocol with varying degrees of success. Nearly 3,000 people have now had the transplant, and they will be followed for 10 years to see how well they do in the long term.

The procedure can require two or more donated pancreases per patient, leading scientists to seek other sources.

On Tuesday, researchers at the University of Minnesota presented their results on transplanting islet cells from pigs. By genetically engineering swine to reduce the rejection response between species, they say the islet cells were able to function in diabetic primates for more than 70 days.

Results from both studies were presented at this week's American Transplant Congress in Washington.