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Clinical trial reveals promise of islet transplants

Islets are clusters of cells within the pancreas containing the insulin-producing beta cells that are critically important in diabetes. This close-up image of an islet shows beta cells in green.

Islet transplantation has remained experimental since the 1970s, but recent clinical trial outcomes at the University of Minnesota Schulze Diabetes Institute (SDI) are revealing the procedure’s promise as a standard therapy, and even a cure, for type 1 diabetes.

In 2008, SDI was selected as one of three principal sites to test human islet transplants to treat type 1 diabetes in Phase III clinical trials — the final round of study before the U.S. Food and Drug Administration determines whether the procedure can be used as a standard therapy for diabetes.

Melena Bellin, M.D., a University pediatric endocrinology fellow and physician involved in the clinical trials, says new protocols using islets from two to four donors per transplant patient and advances in antirejection drugs have significantly improved patient outcomes.

Previously, about 10 percent of transplant recipients achieved insulin independence post-transplant, she explains. Today, the figure is nearly 90 percent. “More than 50 percent [of patients] have maintained insulin independence at their five-year follow-ups,” Bellin says.

The University also has had good results with single-donor islet transplants. “Since 2000, about 50 percent of our insulin-independent patients have needed only one donor transplant, including several patients who are now 8 to 10 years out from their transplant and insulin independent,” Bellin says. “This is one way the U of M stands out from other centers doing islet transplants.”

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