Islet Transplantation (Continued)
Researchers use specialized enzymes to remove islets from the pancreas of a deceased donor. Because the islets are fragile, transplantation occurs soon after they are removed. Typically a patient receives at least 10,000 islet "equivalents" per kilogram of body weight, extracted from two donor pancreases. Patients often require two transplants to achieve insulin independence. Some transplants have used fewer islet equivalents taken from a single donated pancreas.
Transplants are often performed by a radiologist, who uses x rays and ultrasound to guide placement of a catheter—a small plastic tube—through the upper abdomen and into the portal vein of the liver. The islets are then infused slowly through the catheter into the liver. The patient receives a local anesthetic and a sedative. In some cases, a surgeon may perform the transplant through a small incision, using general anesthesia.
Islets begin to release insulin soon after transplantation. However, full islet function and new blood vessel growth associated with the islets take time. The doctor will order many tests to check blood glucose levels after the transplant, and insulin is usually given until the islets are fully functional.
What are the benefits and risks of islet transplantation?
The goal of islet transplantation is to infuse enough islets to control the blood glucose level without insulin injections. Other benefits may include improved glucose control and prevention of potentially dangerous episodes of hypoglycemia. Because good control of blood glucose can slow or prevent the progression of complications associated with diabetes, such as heart disease, kidney disease, and nerve or eye damage, a successful transplant may reduce the risk of these complications.
Risks of islet transplantation include the risks associated with the transplant procedure—particularly bleeding and blood clots—and side effects from the immunosuppressive drugs that transplant recipients must take to stop the immune system from rejecting the transplanted islets.
Vegetable Lasagna Boston Brown Bread Cocktail-Hour Tuna Tartare Fresh Spinach and Mushroom Medley Tarragon and Lemon Chicken Salad Braised Parsnips and Winter Vegetables Alsatian Rub Stuffed Radicchio Leaves Marshmallow Fruit Squares Roasted Zucchini Onion and Garlic Spread
There are many things to be said about the American holiday of Thanksgiving. While much of the "legend" of the holiday is probably propaganda (Were the Pilgrims and Indians as close as we'd like them to be? Would a harvest celebration in New England really be this late in the year, when there would have likely already been snow? And what about the turkey, which has changed so much from the bird Ben Franklin touted for our national emblem?), there is something to be said for...