Islet Transplantation Program

Islet transplantation is an emerging alternative treatment to transplanting the whole pancreas. Islet transplantation can be performed safely without an operation, and results of islet transplantation in reversing diabetes approaches that of whole pancreas tranplantation. The University of Michigan Transplant Center plans to initiate an islet transplantation program, bringing its broad and longstanding experience with pancreas transplantation to the field. Over two hundred pancreas transplants have been performed at the University of Michigan, making it one of the largest pancreas programs in the country. The islet tranplant program integrates clinicians and scientists from several disciplines in a unified program.

In islet transplantation, the pancreas from an organ donor is processed in the laboratory to obtain islet cells, of high quality and purity. Islet cells are cells within the pancreas that produce a variety of hormones, including insulin. These cells are located in clusters, called islets, within the pancreas. The cells within the islets that produce insulin are called beta cells. The pancreas also contains exocrine cells which produce enzymes that aid in digestion of food. The islets are required for the treatment of diabetes, but the exocrine cells are not needed. In fact, the exocrine cells may be the primary target for rejection of a whole pancreas transplant.

The goals of the islet isolation process in the laboratory is to separate the islets from the exocrine cells. This is done through a highly specialized process by which the pancreas is exposed to an enzyme which breaks apart the pancreas into islets and exocrine cells. The islets are purified by being physically separated from the exocrine cells using a density gradient. The purified islets are then capable of producing insulin normally. The purified islets will be infused into the patient's liver via a blood vessel called the portal vein, using interventional radiology techniques. There is no surgery involved. However, as a recipient of islet transplant, the patient will need to take anti-rejection medications.