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From America On-Line:

I have searched medline and I have e-mailed to three international institutes that boast five-year successes and still going with islet cell transplants in patients who underwent simultaneous organ transplants for kidney and liver. So, theoretically, would you not agree that there have been some successes?


The possibility of having an islet cell transplant instead of a lifetime of injections, blood sugar tests and a long term threat of complications is immensely appealing not only to patients, but to a great many investigators. And yes, autografts, especially when given into the portal vein, seem to work fine, and whole pancreas transplants with a kidney transplant certainly extend life in diabetics with end-stage renal disease. Allografts also work where the pancreas has had to be removed; but require immunosuppression.

For young Type 1 Diabetics, islet cell transplants would have to be xenografts (that is, from another species), in order to meet the need. They also have to be encapsulated to avoid the need for long term immunosuppression and finally they have to be shown to work for an extended period of time. Progress has certainly been made; but real availability is still many years away. For the time being, it seems best not to overstate the case for transplants, and thereby to diminish the effort to achieve good control using intensive insulin therapy or a pump.


Original posting 5 Nov 96


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