Diabetes Mellitus: Transplant Surgery vs. a Tissue Engineered Future

ChEMS Department Seminar

Featuring Clarence E. Foster, III, M.D., FACS
Director, Kidney and Pancreas Transplantation
UC Irvine Medical Center

Location: Engineering Tower 204

Free and open to the public 

Abstract:
Exogenous insulin was recognized as a treatment for Diabetes Mellitus (T1DM) more than 80 years ago. The Beta Cells of the Islets of Langerhans, are the pancreatic structures that produce insulin.  Unfortunately, many patients develop life-threatening complications when using exogenous insulin therapy. The gold standard for this at-risk group of patients is strict monitoring and control of their serum glucose. This care method is recommended by the Diabetes Control and Complication Trial Research Group (DCCT). In patients that can achieve tight glucose control, there is a significant decrease in secondary T1DM complications. Yet, despite this control technique, many patients still develop hypoglycemic unawareness with associated neurologic sequelae. It is this group that is ideal for Beta Cell Replacement Therapy (BCRT).

The last 20 years have seen an increase of successful human pancreas transplantation. These extensive gains were achieved by the improvement of immunosuppressive agents. T1DM diagnosed patients are presently candidates for either Pancreas Transplant Alone (PTA) or Clinical Islet Transplantation Alone (ITA). The limitations of both strategies include the need for immunosuppression and a limited human pancreas organ supply.

The speaker will share his 10 experiences in performing PTA, as well as ITA procedures, as a strategy for Beta Cell Replacement for T1DM. During this discussion, tissue engineering and cell replacement therapy will be explored as new options that may open new treatment opportunities for patients with T1DM. For example, stem cells have recently generated excitement as a potential cure for many diseases that would benefit cell replacement strategy, such as T1DM.  Beta Cell Replacement Therapy from a tissue engineered cell line could potentially increase the supply of cells available for transplant. Another potential benefit may be that these cells could, ideally, be modulated in vitro in order to decrease or abrogate the need for immunosuppressive agents.