Pancreatic Islet Cell Transplantation

by Cynthia M. Johnson, MA

Definition

Pancreatic islet cell transplantation is the transfer of islet cells from a donor pancreas to another person. Islet cells contain beta cells that the body needs to make insulin. Type 1 diabetes happens when the body's immune system attacks and destroys beta cells. Newly transplanted islet cells can make insulin. This may reduce or eliminate the need for insulin injections.

The procedure is being studied as a method to treat people with chronic, uncontrolled type 1 (and some type 2) diabetes.

The Pancreas

Reasons for Procedure

This procedure may be done on people with severe hypoglycemia (low blood glucose) and those who cannot control their diabetes using other methods.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

Excess bleeding
Problems from anesthesia, such as wheezing or sore throat
Infection
Blood clots
Damage to nearby organs
Transplanted islets that do not work as they should
Antibodies develop against the donor cells
Side effects from the medicines needed to stop the body from rejecting the transplanted cells

Things that may raise the risk of problems are:

Smoking
Drinking alcohol
Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

Your care team will determine if you are eligible for a transplant. If approved, it may take months or years to find a donor.

The surgical team may meet with you to talk about:

Anesthesia options
Any allergies you may have
Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
Fasting before surgery, such as avoiding food or drink after midnight the night before
Whether you need a ride to and from surgery
Specialists you may need to see
Tests that will need to be done before surgery, such as blood tests to find a donor match

Anesthesia

The doctor may give:

Local anesthesia—the area will be numbed
General anesthesia —you will be asleep

Description of Procedure

Small incisions will be made in the abdomen. A small plastic tube will be placed through the incision and into a major blood vessel of the liver. An ultrasound will be used to guide the tube to the right location. The donated islet cells will be injected through the tube. The cells will travel through the vein and attach to the liver.

Immediately After Procedure

After the operation, you will be taken to the recovery room for observation. Your blood glucose levels will be monitored.

How Long Will It Take?

One hour

Will It Hurt?

Abdominal pain is common in the first 2 hours. Medicine can help.

Average Hospital Stay

3 to 8 days

Post-procedure Care

At the Hospital

Right after the procedure, the staff will:

Give pain medicine
Give medicines to stop the body from rejecting the transplanted cells. These will need to be taken for life.
Teach you when to check your blood glucose levels
Determine how much insulin you need to manage your diabetes

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

Washing their hands
Wearing gloves or masks
Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

Washing your hands often and reminding visitors and staff to do the same
Reminding staff to wear gloves or masks
Not letting others touch your incisions

Problems to Look Out For

Call the doctor if you are not getting better or you have:

Signs of infection, such as fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision
Cough, shortness of breath, or chest pain
Nausea or vomiting
High or low blood glucose levels

If you think you have an emergency, call for medical help right away.

RESOURCES:

American College of Surgeons
https://www.facs.org

American Diabetes Association
http://www.diabetes.org

CANADIAN RESOURCES:

Canadian Diabetes Association
http://www.diabetes.ca

Canadian Digestive Health Foundation
http://www.cdhf.ca

References:

American Diabetes Association. Standards of medical care in diabetes - 2021. Diabetes Care 2021 Jan;44(Suppl 1):S1-S244.

Diabetes mellitus type 1. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/diabetes-mellitus-type-1-39. Accessed March 18, 2021.

Islet Transplant for Type 1 Diabetes. University of California San Francisco website. Available at: https://transplantsurgery.ucsf.edu/conditions--procedures/islet-transplant-for-type-1-diabetes.aspx. Accessed March 18, 2021.

Pancreatic Islet transplantation. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/insulin-medicines-treatments/pancreatic-islet-transplantation. Accessed March 18, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 03/18/2021

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