Diabetic Patient Now Insulin Free after Procedure

Diabetic Patient Now Insulin Free after Procedure at The University Hospital

Cincinnati--A diabetic patient is free from taking daily insulin injections, after receiving an islet transplant at The University Hospital on April 8. Surgeons performed the islet transplant on 37-year-old Lois Vicars, a Loveland, Ohio resident. An islet transplant is a less invasive alternative to pancreas transplantation to treat Type I diabetes. The University Hospital is one of only five sites in the United States to perform islet transplants. The patient is among five patients in the world to be insulin-free after an islet cell transplant from a single donor. She was insulin free three days after her procedure. Opportunities for media interviews with the patient and surgeons will occur on Tuesday, April 23 between 2 and 3 p.m. at The University Hospital.

Islets of Langerhans are insulin-producing cell clusters found within the pancreas (about 1 million islets are present in a normal adult pancreas). To perform an islet transplant, islets are isolated from a donor pancreas, purified, and then injected into the recipient through a small abdominal vein. The islets lodge in the liver where they reside and begin producing life-sustaining insulin. To protect against rejection, transplanted patients take a combination of new, potent anti-rejection drugs. The procedure requires a one-hour operation, a two-inch abdominal incision, and a short hospital stay.

At The University Hospital, Horacio Rilo, M.D., and his cellular transplantation team performed islet separation and perfusion. The islets were injected into the recipient in an operation performed by E. Steve Woodle, M.D, professor of surgery and director of the division of transplantation.

To date, the University islet transplant team has performed islet "allo" transplants (islets taken from an organ donor pancreas) in four patients and "auto" transplants (islets taken from a person's own pancreas that was removed for disease) in 11 patients. UC Surgeons successfully performed the first "auto" islet transplant in Ohio in November 2001. The first "allo" islet transplant occurred in February 2000. All transplants to date have been successful with marked reductions or elimination of insulin therapy.

"We are thrilled the patient is insulin free," says Horacio Rilo, M.D., director of cellular transplantation at The University Hospital and associate professor of surgery and pediatrics at the University of Cincinnati. "This will result in major lifestyle changes for her. She will be free from the daily insulin injections and finger-sticks to check her blood glucose."

"In the past year, only three islet transplant centers in the world have been able to achieve success with a single donor islet transplant," says Woodle. "Lois is now insulin-free and the other patients we have performed this procedure on now only need about half the insulin they needed before. They have each had a disappearance or marked reduction in the insulin reactions they experienced before the transplant," says Ram Peddi, M.D., associate professor of nephrology.

"The importance of this success is that Mrs. Vicars only required one donor pancreas to make her insulin-free," says Michael J. Hanaway, M.D., assistant professor of surgery and medical director of the LifeCenter Organ Procurement Organization. "This type of success is the final barrier for islet transplantation to replace the more invasive whole organ pancreas transplant procedure."

"The UC islet cell transplant program brings real hope for so many individuals in Greater Cincinnati afflicted with diabetes," says Jeffrey Matthews, M.D., chairman of UC's Department of Surgery. "However, third party payers and Medicare still consider islet transplantation experimental and do not reimburse The University Hospital or the physicians for the procedure. We hope the success of our program will help change this situation."

Diabetes, the fourth leading cause of death in the United States, is a disease caused by the loss of the body's ability to control glucose (sugar) levels. Type I diabetes is caused by the death of insulin-producing beta cells in the islets of Langerhans located in the pancreas. Exposure to high glucose levels over several years can lead to vascular disease, coronary heart disease, kidney disease, damage to the eyes and nerves, and limb amputation. In the past, treatment for Type I diabetes has been confined to daily insulin injections or kidney-pancreas transplants as life-saving methods to restore pancreas function.

The University Hospital is part of the Health Alliance, an integrated health care delivery system that also includes The Christ Hospital, The St. Luke Hospitals, The Jewish Hospital, The Fort Hamilton Hospital and the physicians of Alliance Primary Care.</p><br>