June 13, 2013  Print

A major national-consortium model for islet cell transplantation has resulted in the development of a life-saving clinical procedure for high-risk type 1 diabetes sufferers with life-threatening ‘hypoglycaemia unawareness’.

The Commonwealth-funded Australian Islet Transplantation Program (ITP) includes researchers and clinicians from Sydney’s Westmead Hospital and Westmead Millennium Institute, the University of Sydney, Melbourne’s St Vincent’s Hospital, St Vincent’s Institute of Medical Research, and Adelaide’s Queen Elizabeth Hospital. 

Results of Australian patients who underwent the islet transplantation procedure have now been published in the American Journal of Transplantation. The paper reports the outcomes of the patients who underwent the procedure, many of whom are now insulin free. These patients were all high-risk type 1 diabetes sufferers experiencing life-threatening and undetectable hypoglycaemia (or low blood glucose) that was unable to be managed with conventional treatments. 

Describing results as “remarkable”, Professor Phillip O’Connell, Chair of the Consortium, Director of Transplantation at Westmead Hospital and Director of Transplantation and Renal Research at Westmead Millenium Institute, said, “This significant research and clinical trial has provided a lifesaving treatment that has the potential to change lives of patients with hypoglycaemia unawareness. “Our advanced islet cell transplant procedure has resulted in many of these patients now being insulin free”. 

Professor Phillip O’Connell, said, “Patients with type 1 diabetes, who suffer from hypoglycaemia unawareness, do not get the usual symptoms when their blood sugar drops.” 

“This can result in prolonged hypoglycaemia, seizures, loss of consciousness, brain damage or even death. There are about 150,000 people with type 1 diabetes in Australia, and of these about 10 percent are affected by ‘hypoglycaemia unawareness’.” Prof O’Connell said. 

Islet cell transplantation is a relatively non-invasive procedure in which insulin-producing islets are taken from organ donors and transplanted into a recipient’s liver. 

The procedure was first conducted at Westmead Hospital in Sydney in 2003, for patients with high-risk type one diabetes and ‘hypoglycaemia unawareness’. 

The islet isolation process requires highly specialised centres, and Westmead and St Vincent’s Hospitals being the only facilities in Australia to perform the islet isolation procedure.  

Professor Philip O’Connell, who was recently announced as President-Elect of the Transplantation Society from 2014-16, said that findings such as the ones reported by the Australian consortium continue to not only improve islet transplantation around the world, but also open up possibilities for other cell therapies through the new model and clinical procedure.

“This same model of care also has the potential to be used for other cell therapies including immune deficiencies and cancer immunotherapy,” said Professor O’Connell.

In 2006 the Australian Department of Health and Ageing partnered with JDRF and granted $30 million to develop clinical islet cell transplantation as a treatment for people with this severe form of type 1 diabetes. This follows an initial pledge of $5 million donation from the Susan Alberti Research Foundation.

Dr Dorota Pawlak, Head of Research Development, JDRF, said, “Dr Philip O’Connell and the consortium’s efforts in the area of islet transplantation have produced internationally recognised results that will speed the progress towards a better life for people with type 1 diabetes.”