Transplantation of Islet Cells from the Pancreas

In type 1 diabetes and in advanced stages of type 2 diabetes, the insulin-producing beta cells in the islets of Langerhans (islet cells) in the pancreas die. The DZD in Dresden (Paul Langerhans Institute Dresden, PLID) has established a clinical center for the transplantation of islet cells, where people with type 1 diabetes are successfully treated.

Transplantation

Dresden University Hospital is currently the only institution in Germany that is able and authorized to transplant islet cells. In a complex process, the hormone-producing islet cells, including the vital insulin-producing beta cells, are removed from the healthy donor pancreas. After isolation of these cell clusters and purification, they are finally transplanted into the recipient's liver. However, barriers to the widespread use of this diabetes treatment are the low willingness to donate organs and the need for lifelong suppression of the immune system of affected people with medication to prevent organ rejection. 

Artificial Pancreas

For this reason, DZD researchers are working on alternatives. Instead of a donor organ, an artificial pancreas might take over insulin production in the future. The islet cells are protected from contact with the body's own immune cells by a Teflon membrane. However, the exchange of hormones and nutrients remains unhindered. Following an initial successful test, further clinical studies at the Dresden hospital are now to confirm the long-term functionality of the artificial pancreas.

Beta Cells From Pigs

In collaboration with researchers from the DZD in Munich (LMU), the PLID is also working with islet cells of animal origin. The idea is an obvious one, as patients have been treated with porcine insulin for decades. Shielded by the Teflon membrane, the animal cells in the bioreactor might deliver insulin without triggering the immune system of those affected. Another approach is to genetically modify pigs so that their islet cells do not trigger an immune response. 

Publications

Ludwig B, ..., Bornstein SR. Transplantation of human islets without immunosuppression. Proc Natl Acad Sci U S A. 2013 Nov 19;110(47):19054-8. doi: 10.1073/pnas.1317561110. Epub 2013 Oct 28. PMID: 24167261; PMCID: PMC3839710.

Bornstein SR, Ludwig B, Steenblock C. Progress in islet transplantation is more important than ever. Nat Rev Endocrinol. 2022 Jul;18(7):389-390. doi: 10.1038/s41574-022-00689-0. PMID: 35578026; PMCID: PMC9109192.

Kemter E, ... Wolf E, Solimena M. Sequential in vivo labeling of insulin secretory granule pools in INS-SNAP transgenic pigs. Proc Natl Acad Sci U S A. 2021 Sep 14;118(37):e2107665118. doi: 10.1073/pnas.2107665118. PMID: 34508004; PMCID: PMC8449372. 

More on This Topic

Transplantation bei Diabetes Typ 1 (diabinfo.de - German only)

Bioreaktor, Zellersatz oder Regeneration? (DZG-Magazin SYNERGIE, 02/2020 - German only)

Von der Zelltransplantation zum Bio-Reaktor (uniklinikum-dresden.de, Archiv, 08.05.2015 - German only)

Artificial Pancreas: Successful Transplantation of Animal Beta Cells (News, 26.10.2017)

 

Podcast

Prof. Barbara Ludwig, PLID, in the diabinfo Podcast on Transplants for type 1 diabetes. (German only)