Issue 118 Item 4 New Radical Treatment for Diabetics Gets Green Light

Treatment uses intravenous transplants of insulin-producing pancreatic cells extracted from dead donors A radical treatment for diabetes invented overseas that uses intravenous transplants of insulin-producing pancreatic cells extracted from dead donors is to be made available for the first time in Japan, maybe by the end of the month.

A group of doctors, headed by Takashi Kenmochi of Sakura Hospital in Chiba Prefecture, has been studying the technique since 1996 and recently finished compiling a manual on the treatment.

Initially, the procedure will only be available for insulin-dependent diabetics, whose pancreas cannot secrete insulin–a hormone that controls the level of blood sugar–and have to inject themselves with insulin to compensate for the defect.

Insulin-dependent diabetics account for 4 percent to 6 percent of the nation’s diabetics, estimated to total more than 6 million.

Pancreatic cells, also known as islets of Langerhans, are spherical cell clusters 0.1 millimeter to 0.3 millimeters in diameter. The pancreas of an average healthy adult contains about 1 million pancreatic cells.

The group is ready to start laying the groundwork for pancreatic transplants as soon as a donor pancreas becomes available. After the pancreas is harvested, the pancreatic cells will be extracted by a centrifugal separator and frozen, the group said.

When the team has built up a supply of the cells, it will begin treatment of the most serious diabetic cases. The cells will be injected into the portal vein, which carries blood from the digestive system and spleen to the liver. The cells, once they take root in the liver, will start secreting insulin.

One of the biggest advantages of the treatment is that, unlike transplanting an entire pancreas, the procedure does not require an operation, reducing the physical stress on a patient.

In addition, doctors need only obtain the consent of the donor’s family to harvest the pancreas.

The manual prepared by the group lists the following criteria that must be met before the treatment can be offered:

— The attending physician shall provide patients seeking the treatment and their families with adequate explanations about the procedure.

— The separation and storage of pancreatic cells must be conducted at medical institutions that meet standards defined in the manual to ensure uniformity in treatment.

— Medical personnel involved in the treatment shall take the utmost precautions to protect the privacy of donors and recipients.

The treatment has been in use overseas since the early 1990s on more than 500 patients, a large proportion of whom were completely cured.

While the transplant of an entire pancreatic remains the most effective treatment, there is a short supply of donor organs and a large waiting list.

The group said that pancreatic cells will be extracted only from pancreases that are not suitable for transplants, so that the treatment will complement pancreatic transplants and not deplete an already sparse resource.

While acknowledging that only a few insulin-dependent diabetics will benefit from the treatment in the early years, the group said the treatment may become applicable to a regenerative medicine-based treatment in which insulin-producing cells are created from stem cells, which possess the ability to metamorphize themselves into differentiate types of cells