Islet Cell Transplantation is again a therapy used in Type 1 Diabetes. It used to be an experimental therapy but with growing experience it is entering normal or common place practice. So Islet Cell Transplantation is done in those individuals with repeated low sugars is hypoglycaemias and whose requirement of insulin is so variable that it is difficult for us to manage a patient with subcutaneous insulin therapy or pump. So here what we do is take the pancreas of a dead donors for example if somebody has donated their organs after death, we harvest their pancreas. Only the islet cells are removed and those islet cells are processed. After processing they are injected into the liver of the Type 1 Diabetes patient. This insulin producing beta cells gets lodges in the liver and starts producing insulin. So earlier these patients did not have any insulin producing cells. Because when we give it from outside, these patients have insulin producing cells now and these insulin producing cells starts producing insulin just like the native cells of the patient but the problem with Type 1 Diabetes is it is an autoimmune disease. So the autoimmune process that has originally destroyed the beta cells also tries to destroy the beta cells that you have injected the cadaveric beta cells. So what one does in this situation is give immunosuppresion to the patient with Type 1 Diabetes. So along with infusion of insulin producing cells into the liver of the patient, we also give immunosuppresion drug. So which suppresses the immunity in this situation, in some select centres where the processing is excellent there are patients who are insulin free or those who are taking insulin for 3 to 4 times a day, and had a very poor quality of life because the sugar was fluctuating too much. So these individuals are using no insulin at all. About 50% of the patient become cured of Type 1 Diabetes but it is an invasive procedure requiring insulin infusion to the liver and autoimmune suppression and it is not for everyone with Type 1 Diabetes.
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