Pioneering Treatments for Diabetes

Since the first pancreas transplant was performed here, the University of Minnesota has been dedicated to finding solutions for people with diabetes.  In 1966, doctors William Kelly and Richard Lillehei performed the world's first pancreas transplant at the University of Minnesota.  This historical event proved that surgery could allow a person with diabetes to live without insulin injections.

In the mid-1960s dialysis and kidney transplantation emerged as treatments for people with kidney failure, but not for people with diabetes.  Diabetic people who had kidney disease were rarely accepted for dialysis because their survival rate was low - but their chances for survival without the procedure were zero.  During that time, doctors Lillehei and Kelly realized that by transplanting both a pancreas and a kidney, they could eliminate diabetes in the patient.  Even so, worldwide results of pancreas transplants were disappointing in the early 1970s.  In the late 1970s, fewer than 10% of pancreas recipients helped patients achieve normal blood glucose levels. 

During the 1970s, there were several notable achievements at the University of Minnesota.  In 1974, the world's first human islet transplant was performed at the University of Minnesota.  In 1978, Dr. David E.R. Sutherland performed the first series of consistently successful pancreas transplants at the University of Minnesota.  He had followed doctors Lillehei and Kelly's work while he was in medical school at the University of Minnesota.  In 1979, the world's first living donor pancreas transplant was performed at the University of Minnesota.

In the 1980s, big improvements were made in pancreas transplantation.  Some advances include new ways to drain the pancreas and better immunosuppression protocols.  Rising success rates in transplantation are closely related to advances in immunology.  In the 1960s, Imuran was introduced and in the early 1980s, Cyclosporine was introduced.  These two medications increased overall success rates of transplants and mitigated the side effects of immunosuppression.  In the mid-1990s, FK506 (also known of as Tacrolimus or Prograf) and mycophenolate mofetil (also known of as CellCept) came on the market.  The introduction of these medications reduced the rejection of pancreases transplants, whether they were done alone, simultaneously with a kidney, or after a kidney transplant.  These drugs have also enabled steroid doses to be greatly reduced or discontinued. 

The Diabetes Institute for Immunology and Transplantation (DIIT) was founded in 1994 to develop and implement cures for diabetes through the disciplines of transplantation and immunology.  The DIIT is recognized worldwide as one of the pioneers and leaders in pancreas and islet transplantation.

Today, the University of Minnesota's transplant program is the largest - and one of the most successful - in the world.  To date, more than 21,000 patients have received pancreas or islet transplants worldwide.  Nearly ten percent of these transplants have been performed at the University of Minnesota.  In addition, the success rate of pancreas transplants has risen rapidly over the past ten years.  Today, over 80% of pancreas transplant recipients achieve normal blood glucose levels.  And, for each patient, doctors now have a wide range of medications to choose from so they can create significantly more effective immunosuppression protocols using smaller, less toxic doses.

Innovations over the years have improved both the transplant process and long-term success rates.  Surgeons at the University of Minnesota Medical Center, a division of Fairview, have performed the most living donor transplants in the world.  Over 3,000 people have donated whole or partial organs in our transplant programs.  Whole or partial organs that can be donated from living donors include: pancreas, liver, intestine, islet, lung, and kidney.  If a transplant recipient receives half of a pancreas from a living related donor, the genetic match will be improved, thereby decreasing the tendency for their body to reject the partial organ.  Or, if a person with diabetes needs both a kidney and a pancreas, they can receive a kidney from a living donor and a pancreas from a deceased donor.  Since the wait time for a kidney from a deceased donor can be long, this enables the person to receive the life-saving transplants they need in timely manner. 

Additional innovations include:

• Modified placement of the transplanted pancreas within the body allows for early detection and reversal of rejection.

• Improved protocols for handling donor tissue lessen the time constraints between procurement and transplantation, allowing patients more time to get to the hospital.

• Transplanted kidneys on a large scale for people with diabetes whose own kidneys have failed.

• Proactive measures to help patients improve the quality of their life and prevent the future complications of diabetes.  Transplantation of a pancreas alone in patients whose diabetes is difficult to control but whose complications have not yet advanced to the point where their kidneys have failed (vs. waiting for the kidney to fail and then performing a simultaneous kidney-pancreas transplant).

• Creation of one of the best islet transplant programs in the world.  The Diabetes Institute for Immunology and Transplantation remains on the cutting-edge of advancements in islet transplantation.