Posted: 17th January 2018
December 14 2017 marks the 10-year anniversary of the first islet transplant performed in Victoria.
“I’m proud that since that first islet transplant in 2007, we have performed islet isolations that have helped 46 people across Australia; with our Victorian partner St Vincent’s Hospital Melbourne we have performed islet transplants for 14 recipients, with the majority of these patients receiving more than one transplant.
“In addition, eight recipients received islet transplants at Queen Elizabeth Hospital in Adelaide and 25 recipients received islet transplants at Westmead Hospital, Sydney,” says Professor Kay, Director of SVI.
The team in Melbourne is part of the Australian Islet Transplant Consortium, offering national access to islet transplantation for people with type 1 diabetes and recurrent hypoglycaemia with hypoglycaemic unawareness.
The consortium has two islet isolation facilities located at SVI in Melbourne and in Sydney’s Westmead Hospital and performs transplants in Melbourne, Sydney and Adelaide.
SVI’s islet isolation team has also isolated islets for 5 pancreatitis patients. Auto-islet transplants refer to taking the patient’s own pancreas out, isolating islets and infusing them back into the patient.
In type 1 diabetes, the insulin-producing cells in the pancreatic islets are destroyed by the body’s immune system and cease to produce insulin. As a result, insulin must be administered several times a day during the patient’s lifetime to keep blood sugar at healthy levels. In some people, this insulin treatment can drop blood sugar levels to dangerous levels without warning (hypoglycaemia), which may lead to a life-threatening loss of consciousness.
Before undertaking an islet transplant, the islets need to be ‘isolated’ from donated pancreases and purified. They are then infused into the portal vein of the patient’s liver.
“Islet transplantation reduces hypoglycaemia in approximately 85% of recipients and allows cessation of insulin in about 50% of cases. Recipients must take immunosuppressive drugs for the lifetime of the islet transplant to avoid transplant rejection and recurrence of autoimmunity, but in the majority of cases their quality of life is greatly improved” says Professor Kay.
Penny Hilsman was 15 when she was diagnosed with type 1 diabetes. “As I got older and my diabetes progressed I had increased difficulty swallowing, experienced locked jaw and clenched teeth and confusion during incidents of hypoglycaemia. One time I had a dizzy spell on Swanston Street in the City (Melbourne); someone had to give me some tea with sugar to revive me.
“I found out about the islet transplant program from an endocrinologist I had been seeing in Melbourne for many years. I was 57 and she said there was nothing else we could do to manage my diabetes, which by then had been diagnosed 42 years earlier. She suggested a transplant to me, saying it was the only remaining option available.
“The transplants haven’t been a cure, but there’s no question she made the right decision in having them.” Penny’s sister Glenda adds, “Before the islet transplants, we couldn’t leave Penny alone for 5 minutes. She now has freedom and independence, and a feeling of worth. The transplant saved her life, and provided her with a measure of dignity.”
Since 2013, the Australian ITP program has been funded by the government’s Nationally Funded Centre program, set up to provide equitable access for all Australians to certain low volume, high cost and highly specialised clinical practices and technologies. JDRF and the Australian Department of Health and Ageing funded the islet program for the initial few years.