Researchers Report Progress in Transplants for Diabetics

University of Miami researchers said Wednesday that they may have found a greatly improved way to perform transplants that can both free diabetics from their dependence on daily insulin shots and minimize the use of powerful antirejection drugs.

Researchers have repeatedly shown that transplanting either whole pancreases or insulin-producing pancreatic islet cells into diabetics can cure their disorder, thereby preventing the blindness, nerve damage and other long-term side effects that normally accompany it.

But the pancreas and the islet cells provoke a powerful immune response in the recipient that requires large doses of antirejection drugs, which leave the patient susceptible to viruses, other infections and cancer. Therefore, the transplants are now performed only in diabetics who have received a liver transplant and are already taking the drugs.

The Miami team believes they have found a way to train the recipient’s immune system not to reject the transplanted tissue without the heavy use of antirejection drugs. This could open the door for transplants for many more diabetics.

“This is a staging for what has been in my experience . . . the most important major step forward,” Dr. Daniel Mintz, scientific director of the University of Miami Diabetes Research Institute, told a news conference.

It “opens up the reality that this disease can be reversed, and permanently reversed,” Mintz said.

The Miami team transplanted bone marrow stem cells, the immature white blood cells that are the progenitors of all other blood cells, simultaneously with the pancreas islet cells.

As the donor stem cells mature in the recipient, researchers believe, they suppress the recipient’s immune system so that it does not attack the transplanted islet cells.