February 20, 2013
Edmonton remains a world leader for islet transplants
More procedures to treat Type 1 diabetes performed here than anywhere in world
EDMONTON – The University of Alberta Hospital has solidified its position as the world leader in a groundbreaking procedure that’s helping Type 1 diabetics control their blood glucose levels without daily insulin injections.
Last year, physicians at the Alberta Health Services (AHS) facility performed 61 islet transplants in 48 patients: 30 from Alberta, 18 from out of province. That’s nearly double the number performed the previous year and at least 10 times more than any other facility in the world.
Vancouver is the only other centre in Canada that offers this treatment option.
“I’m proud we’ve continued to advance the important work we started right here in Edmonton,” says Dr. James Shapiro, Professor of Surgery and Medicine, and Director of the Clinical Islet Transplant Program. “Albertans and Canadians are benefiting from the fact we remain at the forefront of a promising treatment option for this common but devastating disease.”
About 400 islet transplants have been performed in Edmonton since 2000 – more than any other centre in the world, representing about one-third of all islet transplants performed globally.
The Edmonton Protocol, developed by Dr. Shapiro and his team, involves isolating islet cells from a donated pancreas and transplanting them into the liver of an insulin-dependent recipient with severe Type 1 diabetes. The donor islet cells produce insulin which helps the transplant recipient regain control of their blood sugar levels, eliminating or greatly reducing the need for insulin injections. Recipients typically undergo one or two transplants, months apart.
“This isn’t a cure for Type 1 diabetes because patients are required to take anti-rejection medications for life,” says Dr. Shapiro. “But islet transplantation is restoring a high quality of life for many of our sickest Type 1 diabetics and freeing them from multiple, daily insulin shots that can lead to other problems, such as hypoglycemia – low blood sugar levels.”
About nine million Canadians have diabetes; one-tenth of whom have Type 1 diabetes. People who are ideal candidates for islet transplantation are over 18 years of age, have Type 1 diabetes that requires multiple insulin injections per day, and have frequent or severe episodes of hypoglycemia. Type 2 diabetics are not candidates because there are many other treatment options for them, including exercise and changes to diet.
Dave Drager met those criteria when he had two islet transplants in late 2009 and early 2010.
First diagnosed with Type 1 diabetes at age 38, nearly 30 years later he required five insulin shots per day and suffered from severe hypoglycemia episodes that twice landed him in a coma. Today, the 70-year-old Edmonton man says he feels recharged and full of life. His blood sugar levels have stabilized and he requires seven or fewer insulin injections per week.
“Having an islet transplant has given me a new lease on life,” he says. “I’m not restricted by needles or constantly have to check my blood sugar levels. It’s given me the freedom to live my life, travel in my retirement, and exercise without my body shutting down on me.”
Dr. Shapiro credits improvements in isolating islet cells for last year’s increase in the number of islet transplants. Transplant cells must come from the same pancreas and a minimum of 300,000 cells are needed for a procedure. More cells are needed for bigger or heavier recipients.
A donated pancreas contains about one million islet cells and the isolation lab team is now able to isolate up to half of those cells, making more people eligible for the procedure.
“Dr. Tatsuya Kin, Doug O’Gorman and the Clinical Islet Isolation Team are an incredibly skilled and dedicated group of technician-scientists, and we are so fortunate to have them in Alberta,” says Dr. Shapiro.
Each procedure takes about 20 minutes and involves using an IV to flow the cells into a vein in the recipient’s liver.
“We’re pleased we’re able to provide this procedure to more patients and anticipate this program will continue to grow over time,” says Dr. Shapiro. “We also have work to do in raising awareness among patients and their care providers about this treatment option. This is not a research study anymore.”
Physicians and patients interested in learning more about the Clinical Islet Transplant Program in Edmonton are encouraged to visit http://www.islet.ca/ or call 780.407.1501.
The Clinical Islet Transplant Program is supported by AHS, the Government of Alberta, and the University of Alberta in collaboration with the University of Alberta Hospital. Research is supported by the Juvenile Diabetes Research Foundation, the National Institutes of Health in the U.S., and by the Diabetes Research Institute Foundation of Canada.
Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than 3.8 million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.
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