Transplanted islet cells offer so much promise for allowing some diabetic patients to stop receiving insulin that The New England Journal of Medicine has released the findings seven weeks before the planned publication date and other groups have announced plans to study the technique.
Transplant News Network reported on June 1 ("Islet Cells Render Diabetic Patients Insulin-Free") that a study presented at the recent joint meeting of the American Society of Transplantation and the American Society of Transplant Surgeons found that eight adults with type 1 diabetes became free of insulin after receiving transplanted islet cells and an immunosuppressive regimen consisting of sirolimus, tacrolimus, and daclizumab.
The New England Journal of Medicine posted the study on its website (www.nejm.org/content/shapiro/1.asp) on June 6 and plans to publish the final version on July 27. In the study by James Shapiro and colleagues at the University of Alberta in Edmonton, Canada, patients needed islet cells from more than one donor, which the authors said could be a drawback. However, they noted, "less than one third of available cadaveric pancreases are actually transplanted."
The findings with the so-called "Edmonton Protocol" have spurred wide enthusiasm from the transplant community. "This new transplant procedure holds great promise for patients to avoid such life-threatening complications due to diabetes such as kidney failure, blindness, and amputations," said Lisa Kory, executive director of Transplant Recipients International Organization (www.trioweb.org). Two groups announced plans to test islet cell transplants themselves.
* The Immune Tolerance Network (www.immunetolerance.org), a clinical research project of the National Institutes of Health and the Juvenile Diabetes Foundation, announced on June 6 that it will begin a clinical trial in the fall to test the Edmonton Protocol in 32 transplants at up to eight centers in North America and Europe. The trial will attempt to further assess the technique's effectiveness and identify any long-term risks associated with the immunosuppressive therapies.
* The St. Paul Pioneer Press reported on June 7 that researchers at the University of Minnesota also plan to start transplanting islet cells in 52 patients with type 1 diabetes. Researchers there put an islet cell transplant program on hold last year after side effective occurred, but the protocols have been revised, according to the newspaper. See www.pioneerplanet.com/health/hea_docs/031903.htm.
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