Definition

Islet cells are the cells in the pancreas that make insulin. Pancreatic islet cell transplantation is the transfer of islet cells from a donor to another person. The procedure is being studied as a method to treat select people with chronic, uncontrolled type 1 (and some type 2) diabetes.

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Reasons for Procedure    TOP

Pancreatic islet cells are made up of alpha and beta cells. Type 1 diabetes develops when the beta cells in the pancreas are destroyed. They are destroyed by the body's own immune system. Without these cells, the body is unable to make insulin. As a result, people with type 1 diabetes need daily insulin injections.

Transplants are most commonly used for persons with recurrent severe hypoglycemia without symptoms and/or those who have very difficult to control blood sugars.

• Hypoglycemia occurs when the person is not eating enough, if too much insulin is self-injected, or when injected insulin to fails to adapt to changes in the body's glucose use, such as with intense exercise.
• It can cause serious problems if it lasts too long, such as in someone who does not know it is happening.
• Newly transplanted islet cells can produce insulin. This allows better daily control of the blood sugars with a lower risk of hypoglycemia.

The transplant reduces, or even may eliminate, the need for self-injection.

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

• Toxicity from immunosuppressive agents
• Injury to the liver or the pancreas
• Cholesterol problems
• Sensitization—Formation of islet cell antibodies that increase the chance of rejection for this or any future transplant. This may occur from a previous transplants, a blood transfusion, or pregnancy.
• Return of diabetes symptoms that need to be treated with resumption or increased use of self-injected insulin
• Nausea, vomiting, and abdominal pain
• Bleeding
• Infection
• Blood clots
• Worsening of kidney function
• Worsening of high blood pressure

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

• Smoking
• Drinking
• Chronic diseases, such as diabetes or obesity

What to Expect    TOP

Call Your Doctor    TOP

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
• Cough, shortness of breath, chest pain, or severe nausea or vomiting
• High or low blood glucose levels

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