Islet Cell Transplantation
Clinical Research Program
For Patients
NewYork-Presbyterian Hospital/Weill Cornell Medical Center has
established an exciting new treatment, islet cell transplantation
for patients with type 1 diabetes, and is currently in the process
of evaluating candidates for this research study.
Our islet transplantation program is modeled after the highly
successful islet transplantation protocol developed by the researchers
in Edmonton, Canada, who have had unsurpassed success in making
islet cell transplant recipients insulin-free for prolonged periods
of time after islet transplantation. The most recent data from
the Edmonton group suggests that 80% of recipients are off of
insulin one year after their transplant. The success observed
at Edmonton has inspired several transplant centers throughout
the United States, including ours, to develop an islet cell transplant
program that incorporates several of the features responsible
for the success observed with the Edmonton protocol.
Islet cells are the cells located within the pancreas that are
responsible for making insulin. Since your own islet cells were
destroyed by your immune system, causing your diabetes, you may
be eligible to participate in this research study.
In islet cell transplantation, islet cells are removed from the
donor's pancreas and the cells are then injected into the portal
vein of your liver, where they are able to enter the liver and
produce insulin (see picture below). You are usually required
to be in the hospital for only one or two days after the injection
of islet cells.
Because you will be receiving islet cells from another person,
you will need to take medications that suppress your immune system
so that the immune system does not try to destroy the new cells.
You would need to take these medications for as long as the islet
cells continue to work.
In addition, two or three separate islet cell infusions may be
necessary in order for you to receive enough cells necessary to
control your blood glucose. Because of that, you may still be
required to take insulin after the first transplant, although
the amount of insulin needed will be much less than the amount
you took before the transplant.
There are some risks associated with this experimental procedure
that will be explained in greater detail if you enter the evaluation
process.
You may be a candidate for islet cell transplantation
if you:
-
Have had type 1 diabetes (also known as
juvenile diabetes) for more than 5 years,
and
-
Experience hypoglycemic unawareness (for
example, you no longer feel shaky, sweaty, or a rapid heartbeat
when your blood sugar is low), or
-
Have been hospitalized several times in
the past year for low blood sugar and/or high blood sugar, or
-
Have complications of diabetes such as
retinopathy, kidney problems, or neuropathy
You will not be a candidate for islet cell transplantation
if you:
-
Are less than 18 years of age or more than
65 years of age
-
Have type 2 diabetes (also known as adult-onset
or non-insulin dependent diabetes, which is usually treated
with pills or a combination of pills and insulin shots)
-
Have progressed to end-stage kidney disease
The screening process involves several steps, outlined
below:
-
Your endocrinologist will be asked to fill
out a questionnaire as an initial assessment of your potential
to become an islet candidate
-
If you pass that screening questionnaire,
you will be invited to come to the hospital for further testing
to ensure that you are healthy and to ensure that the risk of
undergoing islet cell transplantation is minimal. This screening
process includes:
-
Blood tests
-
Tests that determine if your pancreas
still makes some insulin
-
Meeting with our social worker
-
Diagnostic tests (such as electrocardiogram
(EKG), chest x-ray, ultrasound of your liver, stress test)
-
You will also be asked to follow up with
several physicians who you would normally see on a regular
basis (dentist, gynecologist (females only), eye doctor)
To learn more about islet cell transplantation and be screened
as a potential candidate, please call (212) 746-6137 or
email:
[email protected]
Please have the name, phone number, and fax number of your
endocrinologist
when you contact us.
Screening
Form
Or, you may download the screening
form and ask your endocrinologist to complete it and return
it to us so that we may assess your potential eligibility
for this research study.
