Thanks to years of experience and the development of new technologies, Dr. Steven Paraskevas and his team were able to collect islets of Langerhans cells from the pancreas of a deceased compatible donor. Insulin is produced by the beta cells, which make up 65% to 80% of the islets. These islets were then injected into the portal vein of the woman’s liver through a small catheter inserted into the abdomen under local anesthesia. A few days later, the woman began to produce insulin on her own.
Several weeks later, she became completely free of insulin injections. Since then, two other similar transplants have been successfully performed on patients with severe type 1 diabetes. According to recent studies, five years after having this kind of transplant, 60% of the recipients still do not need insulin injections.
Priority is given to people with diabetes who have severe, recurring hypoglycemia despite good adherence to their treatment. These people must also have good kidney function or have had a successful kidney transplant.
It is important to mention that the number of transplants depends on the availability of pancreases from deceased donors. In addition, islets transplant recipients must take a long-term anti-rejection (immunosuppressant) drug that has a number of risks and adverse side effects. It is therefore very important to weigh the potential benefits of a transplant against these risks.
The MUHC is the only centre in Eastern Canada and one of a dozen centres in North America capable of isolating and transplanting pancreatic islets. Dr. Paraskevas hopes to have islets transplantation approved as a treatment in Québec so that more transplants can be done.