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Question:

From Las Vegas, Nevada, USA:

My niece, age 11, was diagnosed with Type 1 diabetes about one year ago. Then I read at children with DIABETES that there was some research going on at the University of Miami regarding implantation of islets. What if any have been the results of that research? Also, is it too late to participate in the clinical trials?

Answer:

Transplantation of the whole pancreas has become a fairly successful operation; but it is unsuitable for young people because it usually involves immunosuppression. The group in Miami, however, are circumventing this by doing what is called a stem cell transplant from the donor bone marrow at the same time. Other groups are greatly diminishing the duration of immunosuppression with the use of new drugs such as Cellcept. Most importantly these seem to improve the outcome by diminishing the need for prednisone in the immediate post-operative period. The procedure is still primarily reserved for cases of Type 2 Diabetes who also have end-stage renal disease.

Islet cell transplantation is being researched all over the world; and has so far not been successful until quite recently when a group in Germany have good results with direct injection into the liver using new technologies in immunosuppression and needing only one donor pancreas. Some promising work at the moment is also being done using xenografts (pig islets) which are encapsulated to prevent rejection and which do not require immunosuppression; they are also of course in plentiful supply. This latter procedure has been demonstrated successfully in primates; but there are no trials yet in which your niece might be enrolled.

DO'B

Original posting 25 Mar 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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