Frequently Asked Questions

What does an islet look like?
Where do islets come from?
Can children get islet transplants?
Why aren't more islet transplants being performed?
Can you provide me with more information about organ donation?
How can I help make islet transplants available to more people?
What is the difference between an islet transplant and a pancreas transplant?

What does an islet look like?

The image to the right is an islet visualized with multi-color, laser scanning confocal immunofluorescence microscopy.  It shows insulin-secreting beta cells in green, glucagon-secreting alpha cells in blue, and somatostatin-secreting delta cells in red.  This photo is courtesy of T.C. Brelje and R.L. Sorenson. 

Where do islets come from?

Islets (Islets of Langerhans) transplanted into people with diabetes come from the pancreas of a deceased organ donor.  A number of critical steps must be taken in a timely fashion to complete an islet transplant.  First, the donor pancreas is recovered by a highly skilled group of physicians.  The University of Minnesota has a dedicated team on call to procure pancreases.  Immediately after recovery, the pancreas is preserved using the two-layer pancreas preservation method - this recently developed method has been found to increase to yield and viability of islet cells.  Third, the pancreas is brought to a facility dedicated to the manufacture of biological products such as human islets in compliance with the FDA's current Good Manufacturing Practices.  The University of Minnesota operates a 45,000 square foot facility called the Minnesota Molecular and Cellular Therapeutics (MMCT) Facility, which isolates islets from the pancreas.  The MMCT Facility is one of only ten Islet Cell Resource Centers funded by the National Institutes of Health.  At this center, six staff members participate in the isolation and purification of islets; the process itself takes more than six hours to complete.  On average, approximately 500,000 of the 1 million islets in a pancreas can be retrieved.  This is the typical islet mass required to maintain normal blood sugar levels.  Once the islets are isolated, they are cultured for two days before transplant. 

During the islet transplant procedure, the cultured islets are slowly infused through a catheter into the portal vein in the liver.  The infused islets follow the blood stream and lodge in small branches of the portal vein within the liver, where they resume insulin production.

Can children get islet transplants?

Our goal is to ensure that islet transplants are safe enough to perform in children. However, there is no study underway at this time that allows people under the age of 18 years to get an islet transplant.  Until the Food and Drug Administration deems islet transplants reliably safe, people under the age of 18 years can not participate in these clinical trials.

Why aren't more islet transplants being performed?

The main reason why more islet transplants are not being performed is that there is a limited supply of donor pancreases from which we can procure islets. There are far more people waiting for islet or pancreas transplants than there are available pancreases. It is our hope that an increase in organ donors and continuing progress in xeno (cross-species, e.g. pig cells) and stem cell research will help address this shortage.

Another reason why more islet transplants aren’t being performed is that they are currently only available as part of clinical trials, which are complex and expensive. Throughout a clinical trial, there is a great deal of monitoring to ensure that patients who receive islet transplants are not experiencing complications. The Food and Drug Administration (FDA) approves and monitors clinical trials, the University of Minnesota's Institutional Review Board reviews clinical trials to ensure that patients are well-informed as to the risks and benefits of participating in clinical trials, and there is a Data Safety and Monitoring Board that monitors the results of clinical trials. Although this oversight slows down the rate at which we can perform islet transplants, this oversight is very important to ensure that islet transplants are done safely and with as little risk to patients as possible. The Diabetes Institute for Immunology and Transplantation (DIIT) would be able to perform clinical trials on more patients if there were more funding available. We welcome your charitable support to help further our clinical research efforts. Please keep in mind, however, that such support does not impact the likelihood of participation in a clinical trial. Charitable support is tax-deductible to the fullest extent of the law by virtue of the DIIT’s affiliation with the Minnesota Medical Foundation of the University of Minnesota Medical School.

Islet transplants appear to be safe and effective and hopefully soon will be performed as part of the "practice of medicine." This means that doctors who are licensed and trained to perform islet transplants could do so without the amount of oversight required in clinical trials.

Pancreas transplants are currently considered "practice of medicine."  Pancreas transplants are a viable option for people interested in islet transplants.

Can you provide me with more information about organ donation?

Organ donors provide people waiting for a transplant with renewed hope. Through donation, a single donor can save or enhance the lives of up to 50 people.  Read more about organ donation on our website.

How can I help make islet transplants available to more people?

One of the most immediate ways to help make islet transplants available to more people is to make a charitable contribution to the Diabetes Institute for Immunology and Transplantation (DIIT) through the Minnesota Medical Foundation (MMF).  Your gift will directly support the DIIT’s innovative and world-renowned research and clinical trials.  Additional clinical trials are needed to further demonstrate the safety and efficacy of islet transplantation and to further improve all aspects of islet transplantation. 

In October 2004, Medicare began paying for costs related to islet transplantation for Medicare beneficiaries with Type 1 diabetes who participate in an islet transplant clinical trial sponsored by the National Institutes of Health.  Once islet transplants are approved by the FDA, they will become more widely available to people.  

What is the difference between an islet transplant and a pancreas transplant?

A pancreas transplant means the whole pancreas is transplanted, with islet cells intact. This procedure is considered part of standard medical care and has been done throughout the world for many years. The success rate for recipients being insulin-free one year after transplant is 80 to 85%; after three years it is 75 to 80%. A pancreas transplant is major surgery requiring general anesthesia and a longer recovery time. Complications from the surgery happen in about 10 to 15% of the recipients, requiring a longer hospital stay or readmission to the hospital.

An islet transplant means the islets are isolated from the pancreas and then are infused into a transplant recipient.  This procedure has not yet received approval from the FDA; the safety and efficacy of the procedure are currently being evaluated through research studies called clinical trials.  An islet transplant is a less invasive procedure, so recipients experience shorter recovery times than pancreas transplant recipients.

People who have a pancreas transplant or an islet transplant to treat diabetes must be on immunosuppressive medications for the rest of their lives to help prevent their body from rejecting the foreign tissue (whether it be a whole pancreas or isolated islets).