BioEd Online

A woman in Japan has had her diabetes reversed by a transplant of insulin-producing cells from her mother. The procedure has given strikingly fast results and marks a departure from previous operations, which relied on cadaver organs as a source of the cells.

The first successful transplantation of such cells, called islet cells, from the pancreas of a non-living donor to a diabetic patient was performed in 2000. Since then, about 100 people have had their diabetic condition reversed by the procedure.

But waiting for a suitable donor can be a problem, particularly in countries such as Japan, where traditional beliefs against removal of organs from the deceased means that donors are in short supply.

For this reason, a team led by Shinichi Matsumoto of Kyoto University Hospital decided to investigate the possibility of extracting islet cells from a live donor. Their first patient was a 27-year-old woman who had become dependent on daily insulin shots after suffering inflammation of the pancreas at a young age. Her 56-year-old mother was the donor.

Delicate procedure

In a day-long operation, the team transplanted about 10mL of tissue from the pancreas of the mother to the daughter. The procedure was a tricky one, since islet cells are notoriously delicate. "It's difficult to extract them and keep them healthy," explains islet transplantation expert Stephanie Amiel of King's College London, UK. She adds that the cells sometimes form clots after the operation.

Matsumoto says that transplants taken from live donors make for healthier cells. Both mother and daughter fared well, he says, and 22 days after the surgery, the young woman no longer needed insulin injections to regulate her blood sugar. "From our experience, this patient has more than double the blood insulin level compared with patients who received one cadaveric islet transplantation," says Matsumoto. The researchers say that people who receive cells from non-living donors tend to become insulin independent only after two or three such procedures.

Amiel says that the daughter's speedy recovery from the recent operation is remarkable given that she only received islets from a portion of the pancreatic tissue; most procedures involve transplanting cells from the entire organ. But Amiel also adds that because the surgery took place in January, the long-term benefits are unclear. "These are quite early days," he says.

Matsumoto says he plans to conduct a further 10 such operations this year.