Islet cell donation and transplantation
Islet transplantation is an important therapeutic procedure in most European countries. Islet cell transplantation means hope for patients suffering from life-threatening hypoglycaemia due to diabetes mellitus type 1. In healthy people, beta cells in the pancreatic islets of Langerhans produce the hormone insulin and release it into the bloodstream. If the function of the insulin-producing beta cells is disturbed, life-threatening disorders of the blood sugar level, especially hypoglycaemia, may occur. For a special group of patients with diabetes mellitus type 1, islet cell transplantation is therefore a very successful therapy procedure. The transplantation of islet cells allows the reliable restoration of glucose-regulated endogenous insulin secretion. In addition to pancreas organ transplantation, islet cell transplantation is currently the only clinically available beta cell replacement therapy.
If we want to achieve the best possible use of the available donor organs, we are urgently dependent on the notification of potential donors for islet transplantation.
Simply call 0800-511 500 (for calls from within Germany only) or +49 (0)511 – 563 559 54 (from international locations).
Islet transplantation is indicated for patients with diabetes mellitus type 1 with a highly labile metabolic condition and frequent severe hypoglycaemia. The regulatory situation in Germany is extremely complex. As a result, islet cell transplantation in Germany is not practicable in the existing structures. In the years 2015 and 2016 islet cell transplantation practically came to a halt. Prior to this, there were about ten transplantations per year.
DGFG and the Dresden center for islet transplantation work together
The DGFG and the Dresden center for islet transplantation would like to significantly improve the situation for the benefit of patients. They have been working closely together on the donation of islet cells since 2017. It is hoped that the cooperation will enable patients with diabetes mellitus type 1 to be offered the clinically available options of beta cell replacement therapy (pancreas and islet transplantation) again in Germany. The cooperation enables an efficient use of the already small donor pool from the stagnating organ donation. The Dresden center for islet transplantation is currently the only institution in Germany that can carry out islet transplants.
The following aspects are decisive for the realisation of islet cell donation and transplantation:
- Information of the participants on the medical background of the islet transplantation and the regulatory/legal classification of the pancreatic islands as tissue
- Provide relatives with prompt information on organ and tissue donation; separate consent for the use of pancreatic islets in the case of non-transplantable pancreatic organ
- Early notification of the DGFG by the donor hospital or the collection surgeons
- 24-hour contact person in the DGFG network and the Dresden center for islet transplantation
Islet cells are tissues
In terms of the Transplantation Act (TPG § 1a), the pancreas is an organ subject to allocation. The principle of organ before tissue donation applies here (TPG § 9). If the pancreas cannot be transplanted as a viable organ, it is rededicated to tissue in order to obtain and transplant islet cells. The donation of the islet cells requires the consent to the tissue donation!
Acceptance criteria for islet cell donation
- Donor age: 16 to 60
- Body Mass Index: < 40
- Cold ischemia period: < 20 hours
Dresden Center for Islet Transplantation
At the University Hospital Carl Gustav Carus Dresden an active island transplantation program exists since 2008. It thereby completes the spectrum of available clinical therapy options for diabetes mellitus type 1. These range from conventional insulin therapy, insulin pump therapy, new diabetes technologies and DiaPort treatment to pancreatic organ transplantation. The Islet Transplantation Program under the direction of the Medical Clinic III has a manufacturing license for the processing of human pancreatic islets according to § 13 AMG. A tissue removal permit for pancreatic tissue according to § 20b AMG is available. There is a close cooperation with the Clinic for Visceral, Thoracic and Vascular Surgery. In addition to the preparation and evaluation for an islet transplantation and its realization, a special islet transplantation ambulance guarantees the intensive and professional aftercare of the patients.
