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Researchers
from the University of Alberta report that experimental transplants
of insulin-producing islet cells using a technique pioneered
in Edmonton have now been performed on 122 diabetics in Canada
and 9 centers in the United States.
Dr. James
Shapiro, presenting an update on the technique unveiled two
years ago at Transplant 2000, said 70 percent of the 33 patients
who have received islet transplants from his team have had
no need for insulin injections for two years.
But despite
a growing number of successes for the so-called Edmonton protocol
in freeing Type 1 diabetics of the need for daily insulin
injections, some doctors question whether the results outweigh
the risks.
Dr. David
Harlan, a researcher at the National Institutes of Health
which is sponsoring the study of the Edmonton protocol in
the United States, told The Washington Post the question no
longer was "can this work" but rather "should
we do it."
While
islet transplants do not require conventional surgery, with
a large needle being inserted through the abdominal wall to
transport the islets to the liver, complications reported
in Edmonton have included internal bleeding in two patients,
puncture of the gall bladder in two, and clotting in a large
vein in one patient.
Shapiro
said a few patients also experienced infections or reduced
kidney function. Harlan said some of the six patients he has
transplanted have experienced anemia, tremor, swelling of
the legs, joint pain and fatigue. And
like patients receiving organ transplants, patients receiving
the islet transplants have to take daily immunosuppressive
medications.
"You're
really substituting insulin . . . for someone using immune-suppressive
drugs," Harlan said. "The question is: Which is
safer long-term?"
Source:
Transplant
Week,
week of May 5, 2002
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