why wouldn’t a pancreatic transplant cure diabetes?
In: 2
It depends on the type. Type 2 is more to do with the insulin your body processes not being used properly.
Assuming you’re talking about type 1, the pancreas isnt the problem. It’s the immune system. The immune system targets the insulin producing cells of the pancreas and kills them off. If it does that with your own organ, it’s likely to do the same from a donation.
What I don’t know is how effective immunosuppressants would be at combatting the attack of a healthy pancreas.
Source: I’ve had type 1 for 20 years.
It can be done in type 1, and is usually in combination with a kidney transplant. Problem is being reliant on anti-rejection drugs for the rest of your life. Next problem is the same problem that caused type 1 in the first place–the body will eventually attack the islet cells of the pancreas and kill them off, yet again. Islet cell transplants and becoming more common (look up Edmonton Protocol) but the anti-rejection is still an issue, which is why ViaCyte is working on an encapsulation method to hide transplanted cells from the immune system. Remember, type 1 diabetes is an autoimmune disease.
Type 2 afik don’t really do this operation-their pancreases are usually fine and produce insulin; it’s just that their bodies that can’t use the insulin correctly so the metabolic issue isn’t necessarily addressed at the pancreas itself. At the start of T2, it’s not a pancreas problem at all, although over the decades they can burn out their beta cells rendering it ineffective in insulin production, but the cause and treatments differ from type 1.
In all the other types of diabetes, I don’t believe transplants are common, perhaps with the exception of some 3C’s who may have had a complete pancreatectomy or partial but you’d have to look up references for that.
For gestational diabetes, the issue isn’t in the pancreas at all, but rather the placenta.
I don’t know about all of the MODY types and depending on which type of MODY a transplant may not be necessary nor effective, I’m not sure. Some people with MODY are treated like T1, some are treated like T2 and there’s several types of MODY (genetic).
Neonatal diabetes may be permanent or transient and I haven’t heard of transplants in those cases either.
Steroid induced diabetes is often treated as type 2 so also haven’t heard of transplants for those cases.
Diabetes related to Alstrom Syndrome they are treated like T2, while people with Wolfram Syndrome DM are treated like type 1; however, some with Wolfram have T1 but some have diabetes insipidus which isn’t related to the pancreas at all. I have no data on transplants in these cases.
For CFRD (Cystic Fibrosis Related Diabetes) transplants are still rare, with perhaps a 2-year success rate.
They can do transplants for people with Type 1 diabetes, but it comes down to risk vs reward.
A type 1 diabetic has to continually monitor their blood glucose and inject insulin multiple times a day. Both of these can generally be accomplished by having an insulin pump surgically implanted, meaning less sticks per day and less (not no) risk of infection. They can live a fairly normal life as long as they monitor their diet and keep their port clean.
A transplant patient has to take anti-rejection medication for the rest of their lives. They are at increased risk of infection, because we are suppressing their immune system to protect the transplanted organ. The medications have their own side effects as well/risks associated. Additionally transplants don’t last forever, the half life for a pancreas is about 7-14 years. That’s better than some other organs, but still, depending on your age when you get the transplant, you may end up needing another surgery down the line.
Basically, if you can be on insulin from a pump, it’s a safer option. Transplants are more often used for patients that for some reason can’t be controlled by regular insulin injections, have some other conditions, or are having kidney issues that also require a transplant.
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