| Reasons for Procedure
| Possible Complications
| What to Expect
| Call Your Doctor
Islet cells are the cells in the pancreas that make insulin. Pancreatic islet cell transplantation is the transfer of islet cells from a donor to another person. The procedure is being studied as a method to treat
select patients with chronic uncontrolled
(and some type 2) diabetes.
Copyright © Nucleus Medical Media, Inc.
Reasons for Procedure
Pancreatic islet cells are made up of alpha and beta cells. Type 1 diabetes develops when the beta cells in the pancreas are destroyed. They are destroyed by the body's own immune system. Without these cells, the body is unable to make insulin. As a result, people with type 1 diabetes need daily insulin injections.
Transplants are most commonly used for persons with recurrent severe hypoglycemia (low blood sugars) and/or who are also receiving kidney transplants. Newly transplanted islet cells can produce insulin. This allows better daily control of the blood sugars with a lower risk of hypoglycemia. Hypoglycemia occurs when too much insulin is self-injected or when injected insulin to fails to adapt to changes in the body's glucose use. The transplant reduces, or even may eliminate, the need for self-injection.
If you are planning to have a transplant, your doctor will review a list of possible complications, which may include:
- Toxicity from immunosuppressive agents
- Injury to the liver or the pancreas
- Cholesterol problems
- Sensitization—Formation of islet cell antibodies that increase the chance of rejection for this or any future transplant. This may occur from a previous transplants, a blood transfusion, or pregnancy.
- Return of diabetes symptoms that need to be treated with resumption or increased use of self-injected insulin
- Nausea, vomiting, and abdominal pain
- Blood clots
- Worsening of kidney function
- Worsening of high blood pressure
Factors that may increase the risk of complications include:
- Excess intake of alcohol
- Kidney disease
- Bleeding disorders
What to Expect
A review board will determine if you will be eligible for a transplant. Once on the transplant list, one may have to wait months or years for a suitable donor.
Your doctor will order blood tests. A physical exam will be done. These tests will assess the extent and severity of diabetic complications. This includes damage to the kidneys.
You and the donor will be carefully screened by blood and serum to optimize a match. The better the match, the less chance for islet rejection.
may be used.
Local will numb the area. You will be asleep with general anesthesia.
Pancreas transplant surgery is major surgery and requires special expertise in select medical centers. The cells are delicate and may fail even in the best of circumstances.
Before surgery, islet cells are removed from a donor pancreas. Usually, these cells are used within the next 24 hours.
An incision will be made in the abdomen. A small plastic tube will be placed through the incision and into a major blood vessel of the liver. An
will be used to locate the right position. Islets cells will be injected through the tube. The cells travel through the vein and attach to the liver. When successful, they will begin making insulin.
Your blood glucoses may be normal immediately following transplantation.
Your immune system may attack the transferred cells. To prevent this type of attack, called rejection, you will be given medications to suppress your immune system.
Similar medications to suppress the immune system are usually needed for the rest of the person’s life to prevent rejection.
The area of surgical incision may sting or burn. Anesthesia will prevent pain during the procedure. After the procedure, some patients experience pain or soreness for a few days. If you have discomfort, ask your doctor about pain medication.
- Keep the incision wound clean.
- Follow your doctor’s instructions about wound care.
- Check your blood glucose frequently. Follow your doctor’s instructions.
- You and your doctor will closely control and monitor blood sugar levels with the a new insulin requirement. The dose of insulin will need to be adjusted after the transplant.
Your doctor may repeat the process several times to transfer more islet cells.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
- High or low blood glucose levels
If you think you have an emergency, call for medical help right away.
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http://www.diabetes.org/living-with-diabetes/treatment-and-care/transplantation/islet-transplantation.html. Accessed September 3, 2013.
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Last reviewed September 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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