Re: Hope to get some answers..

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How Islet Transplants are Done

Historically, the early complications with the exocrine portion of the

graft(98% of the pancreas is exocrine tissue), led to the idea of isolating

and transplanting the islets in a more easy and non-surgical way. It

continues to be deemed a promising approach.

Pancreases for islet isolation are usually procured from cadaver donors.

With a current islet transplant success rate of only 10%, putting a living

donor under surgical risk for islets would generally not be justified

(unlike a pancreas transplant). After the Islets of Langerhans, which

contain the B-(insulin producing) cells, are separated from the exocrine

tissue (islet isolation) by a machine, they may be cultured for 2-3 days

before transplantation. Under X-ray guidance islets are injected into the

recipient's portal vein. Once in the portal vein, the blood flow and

pressure carries the islets to the liver where they encounter small diameter

capillaries that cannot be traversed by the islets. In such a mechanical way

the islets stay in place, and new capillaries incorporate them in an

anatomical form.

An islet transplant alone from another person (allograft) is still on its

way to be perfected . Islets present a special and not fully understood

susceptibility to rejection and to side effects of the immunosuppressants

that prevent the cells from functioning or surviving. Furthermore, there is

not yet a marker to indicate rejection episodes and thus the opportunity to

reverse the immunological attack is missed.

At the present islet-kidney transplantation is performed for individuals

that need a kidney but cannot have extensive surgery. Although the insulin

independence percentage is lower than for pancreas transplant, 1/3 of the

recipients have improved glucose control. Islet transplant alone, though,

for people whose pancreas is removed to alleviate pain from pancreatitis ,

can be done with a 75% success. In these cases the recipient's own pancreas

is the source of the islets (islet autograft, Iaut.) with no need for

immunosuppression. This fact and the appearance of new drugs (now under

experimentation) encourage patients, physicians, insurance companies and

pharmaceuticals to keep trying.

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E.R. Sutherland, M.D., Ph.D.,

E.R. Sutherland, M.D., Ph.D., is Director of the Diabetes Institute

for Immunology and Transplantation and Head of the University of Minnesota

Division of Transplantation. Regarded as the pioneer of pancreas

transplants, Dr. Sutherland and his associates have performed more than 900

pancreas and islet transplants during his 30-year quest to perfect a cure

for diabetes. Many of the doctors who trained as residents and fellows under

his direction have gone on to develop pancreas transplant programs around

the world. While his achievements have brought him numerous awards and

honors, Dr. Sutherland is known among his patients as a man of great

humility who is always available to answer their concerns and who is

determined to give back to them the quality of their days.

http://www.diabetesinstitute.org/people/sutherland.htm

The Diabetes Institute For Immunology and Transplantation Department of

Surgery 420 Delaware Street, SE Minneapolis, MN, 55455 Phone: (612)624-8402

Website: http://www.Diabetesinstitute.org

I hope this helps som .

I hope this finds you and yours well

Mark

Hope to get some answers

> Hi, my name is and i am suffering from chronic pancreatitis. A

> week or so ago my neice Debbie wrote to help get some information

> for me. I am not a computer user, so please bear with me. Anyway,

> she received an e-mail back from Shirly and passed the message on to

> me. I in turn wrote to Shirley, however, I'm not sure if the message

> was received since I was not a member at that time. Therefore, I am

> hoping that either Shirley or someone can contact me as I have so

> many, many questions and am not sure where to start or who to talk

> to. I am in the midst of trying to find a surgeon to perfrom a total

> pancreatectomy with an Islet Cell transplant. I would appreciate any

> help I can get. Thanks

>

>

> PANCREATITIS Association, Intl.

> Online e-mail group

>

> To reply to this message hit & quot;reply & quot; or send an e-mail

to: Pancreatitis (AT) Yahoo

>

>