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Alberta surgeon pioneers transplant for diabetics

Last Updated: Sunday, February 6, 2005 | 4:04 PM ET

An Edmonton doctor has led the world's first transplant of insulin-producing cells from a living donor, pioneering a surgery that could mean faster, better treatment for diabetics.

Dr. James Shapiro and Japanese surgeons removed part of the pancreas from a 56-year-old woman and took out insulin-producing cells called islets. Then they successfully transplanted them in the woman's 27-year-old daughter.

Shapiro, who led a team at the University of Alberta that developed the so-called "Edmonton Protocol" for transplanting islet cells, said the operation represents a "dramatic step forward."

Patients who underwent earlier islet transplants were able to stop their daily injections of insulin.
Patients who underwent earlier islet transplants were able to stop their daily injections of insulin.

Until now, the islets had to be taken after people died, slowing the process and making it hard to find healthy pancreases.

"Our waiting lists for islet transplantation at the University of Alberta today are increasing all the time and some of our patients have to wait two, sometimes three years, or sometimes longer, for their transplant," he said, announcing the transplant on Thursday.

"These patients have very unstable diabetes. If they could be treated sooner it would be helpful to them."

The surgery was conducted on Jan. 19 at Kyoto University in Japan, where living donor transplants are more common.

Islet transplants end insulin dependence

Diabetes leaves the body unable to produce its own insulin, a hormone that regulates sugar in the blood. Type 1 diabetics must inject themselves daily with insulin.

Under the Edmonton Protocol, islet cells are removed from donated pancreases and put into the livers of people with severe Type 1 diabetes. Shapiro and his Edmonton team have performed the transplant on 72 Canadians since they started in 1999.

Almost all of the patients immediately began producing insulin and the majority were able to stop their injections.

One stumbling block, however, was that the organs had to be harvested from the deceased.

This surgery helps solve that problem, Shapiro said.

"I think it provides an opportunity ahead for an individual that's waiting for an islet transplant to go and talk to their family members and say, hey, would any of you be willing to consider a donation of part of your pancreas on my behalf."

Surgery still has to be approved, tested more

The insulin cells still have to match and the procedure carries some risks for both donor and recipient, he warned.

Still, the living transplant holds the potential of a cure for Type 1 diabetics such as Jason Turner, who has lived with diabetes for 23 years.

"My mom told me that if there's anything she could do, if she could give her pancreas for me, she would do it in a second, and I suppose there might be that opportunity now," Turner said.

Shapiro said it may take months for Canadian officials to approve the surgery and it has to be tried many more times before it can be used widely.

Almost 200,000 Canadians have insulin-dependent diabetes, a condition that's one of the leading causes of death. People with diabetes have an increased risk of developing heart disease, stroke, kidney disease and blindness.

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