Islet transplants somewhat beneficial to diabetes sufferers: study

A new study of anexperimental treatment for Type 1 diabetes suggests that although the procedure isn't abreakthrough, it has some benefits.

The study, published in Thursday's issue of the New England Journal of Medicine, followed 36 adults with Type 1 diabetes who received islet cell transplants at centres in Europe and North America. It was the first long-term, international analysis of this type oftreatment.

The islet cells were harvested from the pancreata of deceased donors and then transplanted. Type 1 diabetes is an autoimmune disorder in which islets are destroyed and the body loses its ability to make insulin.

Of the subjects, 21 stopped using insulin for at least part of the trial, but about three-quarters relapsed and were back to using the hormone within two years.

Gail Thorburn was one of five participants who wasfree of insulin after two years. Now, nearly five years after the operation, she's back on it. "So, if I have to take a little bit of insulin so that the little islets last a little bit longer, I'm all up for it," Thorburn said.

All of the people showed some benefits, such as protection from dangerous bouts of hypoglycemia that can cause damage to diabetic bodies.

"I think from the scientific point of view, we don't have to go that much further before we reach the point where everybody, ormost patients will in fact be free of insulin," said Dr. James Shapiro of the University of Alberta, who led the clinical trial of what's called the Edmonton protocol. "We're not there today."

Procedure costly, may cause side-effects

However, the procedure concerns Dr. Jonathan Bromberg, a transplant surgeon at the Mount Sinai School of Medicine in New York. Each transplant costs up to $40,000, and there are serious side-effects caused by the immune-suppressing drugs that transplant patients take, he said.

The results don't warrant turning islet transplants into a standard treatment,Bromberg said.

"I do not believe that islet transplantation is aclinical entity that is ready for wide dissemination. It's not ready for prime time."

Shapiro's team is trying to advance the procedure to get more mileage out of the insulin-producing cells and improve the immune-suppressing drugs.

While still experimental, more than 600 people worldwide have received transplants under the Edmonton Protocol, which is being done in Germany, Switzerland, and several centres in the U.S.

It remains a treatment of last resort for those who have no other way of controlling their illness.