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Keeping Islets in the Family
June 25th, 2012
Dear Mr. King-
I would like to know about harvesting Islet cells. My mother is about to die of Cancer and my 12 year old son has type 1 diabetes. How do I find out if genetically my mother’s cells may be well suited to being harvested and implanted in one of your cell systems or elsewhere with less chance of rejection? Is there any benefit to getting her cells or is it not worth the effort? How can they be harvested and saved for a period of time until your system comes available. I would be grateful to have the contact details of one of your researchers that could answer my questions.
Kind Regards
GC
Dear GC,
The Islet Sheet is not going to require tissue matching, so the blood relationship between your son and his grandmother does not affect the probability of success. If you were considering conventional islet transplantation, it would improve the likelihood of success. However, at this time islet transplantation is not performed on children because of the major risks of long-term pharmaceutical immune suppression.
Islets can be frozen for years and used later. The loss of function is around 25% per freeze-thaw cycle.
Your mother’s pancreas could be donated on her death. However, I checked and found out that islet programs do not accept such pancreases because of the risk of cancer cells being in the islets. A law of medicine is “first, do no harm,” and introduction of cancer is thought to be possible when using a donor with cancer. For similar reasons, donors with viral infections (hepatitis, HIV) are excluded too.
Sorry to give you a negative assessment of the hope that your mother’s death could bring a better life for your son. The good news is that, at twelve, your son is much less vulnerable to diabetic vascular disease than an adult type 1 diabetic. If he can keep reasonable control of his glucose with insulin and blood sugar testing, there is a good chance that the Islet Sheet will be available before he is an adult.
And Dr. Paul Johnson, who treats young diabetics at Oxford University, believes that the Islet Sheet might be useful for treating young diabetics. Children have always been excluded from islet transplantation because of the side effects of pharmaceutical immune suppression coupled with their relatively low risk from diabetes complications. The Islet Sheet is different from islet transplantation in two important ways. First, we will not use any immune suppression so there will be no toxicity from the usual drugs. Second, the sheet can be removed and replaced, so the risk of the procedure is small. Dr. Johnson thinks there is a good chance that the Islet Sheet will be clinically justified for young diabetes.
I hope his prediction is right.
Best regards,
Scott King
