Posts Tagged ‘diabetes’

10 Years and Still Diabetes Free – Islet Cell Transplant Patients Celebrate Anniversary of Life-Changing Procedure

islet-trans-patients“I feel free. I feel normal.” That’s what Emory Transplant Center patient Laura Cochran says of her life since having a pancreatic islet cell transplant to treat her brittle Type 1 diabetes.

Last week, Cochran, along with the Emory Transplant Center team and fellow patient Rob Allen, gathered to celebrate the 10-year anniversary of their participation in a clinical trial for their severe Type 1 diabetes. Type 1 diabetes is an autoimmune disease in which the pancreas ceases to produce insulin, a hormone that allows people to get energy from food. Type 1 diabetics must take insulin every day to live.

Both Cochran and Allen were diagnosed with Type 1 diabetes as young adults. Allen’s diabetes was controlled with insulin injections for about 10 years until his episodes of low blood sugar became more frequent and more severe. As for Cochran, as her diabetes progressed, she developed hypoglycemia unawareness, where her blood sugar would drop so low so quickly, that she didn’t recognize how low her sugars were. She often became dazed during these episodes and had to be watched at all times. While both benefitted some from insulin pumps, they still needed more relief. Fortunately, they were candidates for a clinical trial at Emory where donor pancreatic islet cells were transplanted to restore insulin production in people with Type 1 diabetes.

Cochran and Allen each received two islet cell transplants from two different organ donors, several months apart. After the first transplant, they both still needed small amounts of insulin injections. After the second transplant, neither Cochran nor Allen needed insulin injections. Both have been insulin free since 2004.

“We transplanted just two teaspoons of islet cells into these patients 10 years ago, and they no longer need insulin injections,” says Christian Larsen, MD, DPhil, professor of surgery in the Division of Transplantation at Emory, and dean of Emory University School of Medicine. “This has been a miraculous transformation.”

Researchers are awaiting FDA approval of islet cell transplants so that the surgery will no longer be experimental. Once approval is obtained, surgeons can perform these transplants on patients who meet the criteria.

“The best part about the islet cell transplants is not having to worry daily about my blood glucose levels getting out of control,” says Allen. “It has been an amazing thing.”

Related Resources

Emory Islet Transplant Program
Islet Transplant For Type 1 Diabetes? Julie Allred’s Story

Transplant for Type 1 Diabetes? Julie Allred’s Story

Julie Allred, Islet Transplant Patient

Julie Allred

When Julie Allred heard that Emory was exploring alternate treatment options for patients with “brittle” or unstable type 1 diabetes, she didn’t realize that she would be the first to receive her transplant via a minimally invasive transplant technique in the interventional radiology suite at Emory Hospital, instead of the operating room.

Julie was diagnosed with type 1 diabetes at age 10. She got her first insulin pump in 1992 and has used several different types of pumps over the years. Despite her efforts to carefully watch her diet and test regularly, she developed many problems over the past couple of years with unstable hypoglycemia (low blood sugar).

Living with hypoglycemia affected Julie’s ability to do many of things she enjoyed. She was constantly worried about how she could or would be affected by the unpredictable changes in her blood sugar, including being caught unaware at night while asleep. Julie was never free—day or night—from the worry of a condition called hypoglycemic unawareness, which unpredictably causes unconsciousness.

“I wanted to have the transplant because I’ve seen so many changes in the treatment of diabetic patients over the years, from the first glucometers to new medications,” Julie says. She was placed on Emory’s islet transplant wait list in early July and received the call eight days later while at her dentist’s office on July 19, which was “a record for the shortest wait,” she notes.

Julie lives several hours from Atlanta in the Charlotte, NC, suburb of Concord, where she has worked as a nurse for the past 20 years in obstetrics and pediatrics. Julie made the trip to Atlanta for her islet transplant at Emory, which was performed by Dr. Kevin Kim, director of interventional radiology and image guided medicine, and Dr. Nicole Turgeon, kidney, pancreas and islet transplant surgeon.

“Our protocol is designed to treat patients who have had type 1 diabetes for at least five years and have experienced severe hypoglycemic unawareness,” reports Dr. Turgeon. She is principal investigator of the study and collaborated with Dr. Kim for more than a year to develop Emory’s protocol.

“We’re able to perform this type of transplant because of Dr. Kim’s expertise in image guided treatment of liver tumors in the interventional radiology suite and Emory’s experience in islet transplantation and the development of new treatment regimens to protect transplant grafts from rejection,” she says.

According to Dr. Kim, “The interventional radiology procedure involves a small access. We thread guidewires and catheters and a central line through the patient’s right side into the portal vein, which leads into the liver. The entire system is through a less than a quarter inch skin access, and there are no stitches required—only a bandage on her skin. There is no general anesthesia required, and the entire procedure is performed under moderate sedation. In fact, we were talking to Julie during the entire procedure.” The fragile islets implanted in Julie’s liver serve to take over the job of making insulin.

Julie Allred with her daughter at Disneyland

Julie with her daughter at Disneyland.

The conventional islet transplant involves a two- or three-inch incision in the abdomen. This open surgical approach can be painful, whereas, Julie experienced no side effects and took only one pain pill following her less invasive transplant.

Julie has been able to gradually taper her insulin from about 50 units a day pre-transplant to 8 to 11 units a day four weeks post-transplant. She is now free from the unpredictable changes in her blood sugar and has had no hypoglycemia.

“My doctor told my mother when I was first diagnosed that I wouldn’t live to age 30 or be able to have children. But because of these advances, I’ve been able to prove him wrong twice,” Julie chuckles. Thanks to the procedure, Julie was able to happily celebrate her daughter Meredith’s 16th birthday at Disney World in January of this year, and turned 43 years old on July 23rd, two days after her transplant.