WASHINGTON -- An experimental transplant operation designed to free diabetics from insulin injections has produced the most promising results since the technique was developed, researchers reported Thursday.
The procedure enabled five of nine patients to significantly reduce their need for daily insulin injections, including one 16-year-old Louisville, Ky., girl who has remained completely independent of injections for more than six months, the researchers reported.
'I'm completely excited,' said Dr. Camillo Ricordi of the University of Pittsburgh, who published the results with his colleagues in the British medical journal The Lancet. 'It's opening up a whole new perspective on cellular transplants.'
The procedure involves removing cells called islet cells from the pancreas of a donor, purifying them and injecting them into a patient. The cells, which are the insulin-producing cells in the pancreas, then lodge in the liver and begin cranking out insulin.
The procedure has shown promise for years in animal studies and some early attempts on human. But the new study has produced the most favorable results to date, experts said.
Although other researchers remained cautious, in part because the patients in the new study were not typical diabetes patients, they said the findings were highly encouraging.
'It's very encouraging, very exciting,' said Dr. David Scharp, a professor of surgery at Washington University in St. Louis who is experimenting with the procedure. '(This offers) new hope for diabetics.'
More than 12 million Americans suffer from diabetes. The disease causes the body to stop producing or react abnormally to insulin, a hormone produced by the pancreas to keep blood sugar in proper balance.
High blood sugar levels can lead to severe damage of the heart, kidneys, eyes, nerves and blood vessels.
The procedure has been tested most extensively for patients with Type 1 or juvenile onset diabetes. Such patients require daily insulin injections, and even then are prone to blindness and other complications. About 1 million Americans have Type 1 diabetes.
The new study, which will be reported next week along with similar findings from other researchers at a transplantation meeting in San Francisco, involved patients who underwent an multiple organ removal operation.
The patients had advanced abdominal cancer, requiring them to undergo the removal of their stomach, pancreas, spleen and parts of the small and large intestines.
Because the patients can be kept alive without the other organs and transplants are considered risky, only a liver transplant is performed. But without a pancreas, the patients become diabetics.
The doctors decided to try the islet transplant because it carries minimal risk.
Two of the nine patients died from complications from the cancer surgery, while a third died six months later when his cancer recurred.
Of the six remaining patients, four out of five only required insulin when they received intravenous nutritional supplements at night. The fifth, patient, Mary Arthur, 16, of Louisville has been independent of insulin since the Jan. 10 operation.
'It (diabetes) could have just destroyed what organs I have left. They saved me from having diabetes for the rest of my life,' she said by telephone.
Previously, the longest published report of a patient who has remained insulin-free from the procedure was two weeks.
Ricordi attributed part of the success to use of an experimental anti-rejection drug called FK 506, which avoided the use of other drugs that may damage islet cells.
Ricordi cautioned, however, that the procedure requires much more refinement and study before being made widely available.
'It's a long way away still. This is just the first very exciting result,' he said.
