Pancreatic Islet Cell Transplantation
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.
Copyright © Nucleus Medical Media, Inc.
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:
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
http://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