使用活体胰岛细胞移植治疗糖尿病

有一项令人印象深刻的成就，可能改善1型糖尿病治疗的预后，日本东京大学医院的一个外科小组从一位妇女采集胰岛细胞移植到她患糖尿病的女儿体内，移植后数分钟内胰岛细胞即开始产生胰岛素。

以前，外科医生切下母亲患者的部分胰腺，是第一例从活体供体采集进行的胰岛细胞移植。一个参加手术的医生是Alberta大学的James Shapiro医生。Shapiro医生帮助制定了Edmonton方案，这是从1999年开始在72例加拿大人开展的手术方案。在这个程序中，胰岛细胞都采自同一供体（尸体）胰腺，移植到了1型糖尿病患者体内。这个方法的一个缺点是大量患者必须等待合适供体达2年甚至更久。使用活体供体进行胰岛移植将使得更多的患者能够进行。

Shapiro医生说，只有10％的1型糖尿病患者适合进行胰岛细胞移植。大约500例糖尿病患者在过去5年中接受了根据Edmonton方案进行的胰岛细胞移植手术，这些患者接受的胰岛细胞均来自尸体。这些受体都必须在其余生中使用免疫移植避免排异反应。

Using Live Donor Cells to Treat Diabetes
 
In an impressive achievement that may result in a better way to treat type 1 diabetes, a surgical team at Kyoto University Hospital (Japan) has taken islet cells from a woman and transplanted them in her diabetic daughter, where the cells started to produce insulin within minutes.

Previously, the surgeons removed a portion of the mother’s pancreas, permitting them to perform the first islet cell transplant from a living donor. One of the participating surgeons was Dr. James Shapiro, of the University of Alberta (Canada). Dr. Shapiro helped develop the Edmonton Protocol, a procedure that has been performed on 72 Canadians since 1999. In this procedure, islet cells are taken from a donor (cadaver) pancreas and transplanted in patients with type 1 diabetes. One drawback with this method is that many of the patients have to wait as long as two years or more for a donor that is suitable. Islet transplants from living donors would allow more patients to get transplants.

According to Dr. Shapiro, only about 10% of people with type 1 diabetes might be candidates for islet cell transplants. Around 500 diabetic patients have received islet cell transplants in the last five years under the Edmonton Protocol, in which the transplants were taken from cadavers. These recipients must take immune-suppressing drugs for the rest of their lives to avoid rejection.