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Pancreatic Islet Cell Transplantation

By

Martin Hertl

, MD, PhD, Rush University Medical Center

Last full review/revision Aug 2022| Content last modified Sep 2022
CLICK HERE FOR THE PROFESSIONAL VERSION

Pancreatic islet cell transplantation is the surgical removal of the pancreas from a recently deceased person, the separation of islet cells from the pancreas, and then their injection into a person with severe diabetes whose pancreas no longer makes enough insulin.

Islet cells are the cells in the pancreas Pancreas The pancreas is an organ that contains two types of glandular tissue: Pancreatic acini Islets of Langerhans (See also Overview of the Digestive System.) The acini produce digestive enzymes.... read more Pancreas that produce insulin, which is the hormone responsible for controlling people's blood sugar levels. Pancreatic islet cell transplantation may be an option for people who have diabetes and whose pancreas cannot make enough insulin.

Transplanting islet cells is simpler and safer than pancreas transplantation Pancreas Transplantation Pancreas transplantation is the removal of a healthy pancreas from a recently deceased person or rarely a part of a pancreas from a living person and its transfer into person with severe diabetes... read more , and about 75% of people who receive an islet cell transplant no longer need insulin 1 year after transplantation and may not need it for many more years. However, the long-term success of islet cell transplantation is not yet proved.

Procedure

Islet cells may be separated from the pancreas of a deceased donor. The islet cells are then transplanted by injecting them into a vein that goes to the liver. The islet cells lodge in the small blood vessels of the liver, where they can live and produce insulin. Sometimes two or three infusions are done, requiring two or three deceased donors. Drugs to inhibit the immune system (immunosuppressants Suppression of the Immune System Transplantation is the removal of living, functioning cells, tissues, or organs from the body and then their transfer back into the same body or into a different body. The most common type of... read more ), including corticosteroids, are needed to help reduce the risk of rejection

Some people must have their pancreas removed because of disorders such as chronic pancreatitis Chronic Pancreatitis Chronic pancreatitis is long-standing inflammation of the pancreas that results in irreversible deterioration of the structure and function of the pancreas. Alcohol use and cigarette smoking... read more . Such people will then develop diabetes even if they did not have diabetes previously. After the pancreas is removed, doctors can sometimes harvest the islet cells from the person’s own pancreas. These islet cells can then be transplanted back into the person’s body (autologous transplantation). Because the cells are the person’s own, immunosuppressants are not needed.

Complications

Even if tissue types are closely matched, transplanted organs and tissue, unlike transfused blood, are usually rejected unless measures are taken to prevent rejection. Rejection results from an attack by the recipient's immune system on the transplanted organ, which the immune system recognizes as foreign material. Rejection can be mild and easily controlled or severe, resulting in destruction of the transplanted organ.

Rejection may occur. Doctors detect it by measuring levels of digestive enzymes that are made in the pancreas enzymes and as well as sugar (glucose) and a protein called hemoglobin A1C in the blood (as for diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Urination and thirst are... read more ).

Other complications result from the procedure. They include bleeding and blood clots in the vein that brings blood to the liver (portal vein).

NOTE: This is the Consumer Version. DOCTORS: CLICK HERE FOR THE PROFESSIONAL VERSION
CLICK HERE FOR THE PROFESSIONAL VERSION
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