Major Diabetes Procedure: First Islet Cell Transplant in Virginia

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Major Diabetes Procedure: First Islet Cell Transplant in Virginia

FIRST ISLET CELL TRANSPLANT IN VIRGINIA

CHARLOTTESVILLE, Va., June 14 ­ Newswise ‹ A Charlottesville area woman may

no longer need the insulin shots she¹s been giving herself every day for 32

years. In a procedure at the University of Virginia Health System, Lori

Ratliff of Ivy became Virginia¹s first recipient of an islet cell

transplant.

Islet cells are cells in the pancreas that secrete insulin, a hormone that

turns glucose (a form of sugar) into energy. Insufficient insulin causes

diabetes. People with Type 1 diabetes, like Ms. Ratliff, inject insulin to

regulate their blood sugar levels.

Ms. Ratliff received the islet cell transplant at U.Va. in a one-hour

procedure June 3. Five days later, she needed to inject only about half the

insulin she did before.

³I am already enjoying the benefits of requiring a lot less insulin by

injection, less risk of low blood sugar and a smoother level of blood sugar

throughout the day,² Ms. Ratliff said. ³I am fortunate for being helped by

this procedure now. And I hope that my participation will contribute answers

to important questions and advance the research to make this sort of thing

available to many, many others with diabetes, children and adults, with and

without complications.²

The procedure requires first isolating over 700,000 islet cells from the

pancreases of two donors. Then the cells were injected into a vein in her

liver. If all goes well, the islet cells attach themselves to blood vessels

in her liver and begin producing insulin.

Though U.Va. doctors were expecting a two-week to four-week wait for the

cells to begin producing insulin, they are encouraged that improvement has

already begun.

³She is doing as well as anybody could imagine,² said Dr. Brayman, a

professor of surgery at U.Va. who injected the cells. ³Her insulin

deficiency has already gone down significantly, and wide swings of insulin

levels haven¹t occurred. So there is some function of the cells already, and

that¹s a hopeful sign.²

Ms. Ratliff, who coincidentally is a nurse at U.Va. in the nephrology

division, was considered an excellent candidate for the transplant because

she suffered from hypoglycemic unawareness, or an inability to recognize low

blood sugar, which can be life-threatening.

³She met all the entry criteria,² Brayman said. ³She¹s extremely insulin

sensitive and also has a low body mass, so the likelihood of success for

complete independence from insulin for her is high.² In addition, Ratliff

did not have any other complications such as heart disease, cancer or kidney

disease. Still, she will have to take two immunosuppressant drugs for the

rest of her life to keep her body from rejecting the islet cells.

Brayman is leading a new Islet Cell Transplant Center at U.Va. with grant

funds from the University of Virginia Ward Buchanan Fund and support from

the Islet Replacement Research Foundation of Gordonsville, Va. He plans

three to five more islet cell transplant cases like Ratliff¹s in the next

year. Dr Jerry Nadler at U.Va., an endocrinologist and associate director of

the program, and his team are collaborating with Brayman to research new

ways to improve islet cell transplants.

Physicians and nurses from the departments of surgery, radiology,

endocrinology/ metabolism and the General Clinical Research Center at U.Va.

cooperated to make Virginia¹s first islet cell transplant a reality.

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June 14, 2004