Diabetes transplant

The Japanese overcame the problem of islet cell transplants to treat type I (Childhood) diabetics by using live, related donors...

There are technical problems with getting islet cells to transplant (which is why the holy grail of embryonic stem cells are being pushed by childhood diabetic groups).

You see, insulin is produced in the pancreas. The pancreas is a huge gland that produces digestive juices (think of it as a ten inch spit gland, that spits out fluid when food starts draining out of the stomach).

In the middle of this big gland are tiny islands of different cells, cells that produce insulin. They are aptly called the Islets of Langerhans...(remember an earlier post where I discussed language showing history? Well, Paul Langerhans the physician who discovered them, has an interesting history..did a lot more than discover these cells.)

So the first problem is that, in brain dead people, often other organs are partly injured by the poor circulation or the lack of oxygen that caused the brain damage. So if you try to get the cells, they are often partially digested by damaged pancreas juices from nearby.

The second problem is that the pancreas is plastered against the backbone.
So surgically, to get donor cells, you can't go from the back--the spine and four inches of muscle is in the way. But if you go from the front, you have to move the liver, stomach, and duodenum out of the way.

Needle biopsy--sticking a needle into the islets-- is an option, but what if you get the wrong cells?

Sounds promising, but one wonders about risk to the donor...because there is a big danger if the pancreas is injured, you get a nasty disease called pancreatitis.

All sorts of research in this area is being done, and although pancreas transplants have been successful, the technical aspects make it still experimental...

Dr. Banning, call your office...