Site - Engineering a home for islets
What is Islet Transplantation?
Sustain - Ensuring islet cell survival
Supply - Creating more islets
What is Islet Transplantation?
The Islets of Langerhans, commonly referred to as “islets” (pronounced “EYE-lets”), are scattered throughout the pancreas. Scientists estimate there are 1 million islets in a healthy, adult pancreas and they make up only 1 to 2 percent of the entire organ. Islets actually are clusters of cells, with each “islet” containing 3,000 to 4,000 cells that all work together to regulate blood sugar. One cell type is the beta cell. Beta cells sense sugar in the blood and release the necessary amount of insulin to maintain normal blood sugar levels.
The Target of Immune System Attack
The immune system mistakenly sees beta cells as “potential danger” and destroys them, causing type 1 diabetes. The loss of these cells means the body can no longer produce insulin, the hormone required to convert food into energy for the body’s cells. Although insulin-producing islet cells cease to function in people with diabetes, the remaining 98 percent of the pancreas continues to function normally, producing digestive enzymes.
Islet transplantation is the process of separating the islet cells from a donor pancreas and then transplanting these cells into a person with type 1 diabetes. Until the late 1980s, isolating these insulin-producing cell clusters from the pancreas was difficult to do. But then Dr. Camillo Ricordi, who now serves as the DRI’s director, developed the “Ricordi Chamber,” an automated method for isolating islets. This dramatically increased the numbers of cells that could be obtained from one organ, and that resulted in the ability to perform islet transplants worldwide.
The traditional islet transplant process itself is a relatively simple, non-surgical procedure performed in about an hour. A catheter (small tube) is inserted into the portal vein that leads to the liver. The patient remains awake for the entire procedure. Similar to an intravenous (“IV”) drip, the purified islets flow from an infusion bag through this vein and are dispersed throughout the liver. There, the transplanted cells develop a new blood supply and begin to produce insulin.
Clinical trials have demonstrated that islet transplantation is the only procedure, outside of a full pancreas transplant, that has restored natural insulin production in patients living with type 1 diabetes. Several patients who have received an islet transplant at the DRI have been able to live without the need for insulin therapy, some for more than 10 years.
In 2016, an unprecedented collaborative Phase 3 study involving the DRI and eight other centers in North America found that islet transplantation was effective in preventing severe hypoglycemia, a particularly feared complication in type 1 diabetes.
A pioneer in islet transplantation, the DRI is now building upon its progress by overcoming the challenges that have limited the procedure to the most severe cases of type 1 diabetes.
DRI Director Dr. Camillo Ricordi invented the “Ricordi Chamber,” an automated method to isolate islet cells from the pancreas. In this animated video, you can see how the isolation process works, from harvesting the donor pancreas to obtaining the insulin-producing cells from the organ and infusing them into the liver, the traditional site of implantation.