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New cell transplantation technique
restores insulin production in diabetics
By Maureen Morley
Researchers are using a new cell
transplantation technique to restore the cells that produce
insulin in patients with type 1 diabetes. The method
is minimally invasive, with few complications. The study was
presented today at the annual meeting of the Radiological
Society of North America (RSNA).
"We used ultrasound guidance to inject donor cells into the
portal vein of diabetic patients, which is accessed through the
skin," said co-author Saravanan Krishnamoorthy, M.D., radiology
resident at the University of Minnesota in Minneapolis. "This
is a safe method of cell transplantation that could potentially
become a same-day procedure."
In type 1 diabetes, the body
does not produce insulin. This typically results from the
destruction of insulin-producing islet beta cells in the
pancreas. Insulin is necessary to metabolize sugar, which is
the basic fuel that all cells need.
With this minimally invasive technique, donor islet cells are
injected into diabetic patients so that the new, healthy islet
cells can restore insulin production, essentially stopping the
progression of the disease. The study included 13 patients with
poorly controlled type 1 diabetes. Fifteen islet cell
transplants were completed-two patients underwent two
procedures to achieve correct needle placement.
"We used a steroid-free protocol to suppress the immune system,
so that the body accepted the transplanted cells," Dr.
Krishnamoorthy said. "We also developed a 'sandwich technique'
to close the access site through the skin, where the islet
cells are injected. The sandwich technique is so-called because
of the layered applications of gelfoam and coil used to close
the access site."
Dr. Krishnamoorthy said that even though percutaneous islet
cell transplantation is currently an experimental procedure,
the sandwich closure is a safe method that prevents many of the
complications common to previous techniques used to transplant
islet cells. Thirty days after the procedure, all 13 patients
were producing insulin without requiring supplemental
injections, and none experienced major complications. Liver
function tests and blood cell counts were monitored carefully
during this time.
In the future, Dr. Krishnamoorthy looks toward the potential
use of stem cells for this purpose, and also the development of
better immunosuppressive medications to keep the body from
rejecting the transplanted islet cells.
Type 1 diabetes, formerly known as juvenile diabetes, is a
debilitating disease that is usually diagnosed in children and
young adults. It can result in significant morbidity, causing
vision loss, loss of sensation that results in severe
infections, fractures and amputations, destruction of major
organ function (e.g., the kidneys) and cardiovascular disease
that can result in complications such as heart attacks. Both
genetic and environmental factors contribute to the
disease.
Maureen
Morley
mmorley@rsna.org
Radiological Society of North
America
http://www.rsna.org
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