OCDEM (Oxford Centre for Diabetes, Endocrinology and Metabolism and the Oxford DRWF Human Islet Isol

25

LIVING

benefit their patients. This group of

clinical researchers had plans and

expectations to continue to improve

not only the effectiveness of the islet

cell isolation, but also of improving

the outcomes of the transplants

themselves.

Isolating islet cells

Clusters of cells distributed

throughout the pancreas ('pancreatic

islets'), control blood glucose in

people who do not have diabetes,

by producing insulin and other

important hormones. For islet

transplantation, islets need to be

extracted (isolated) from a tissue

'matched' donor pancreas. Patients

are carefully screened before being

put onto the waiting list, including

ensuring that conventional insulin

regimens using technology, cannot

stabilise the patient instead. For

someone who is deemed suitable for

an islet transplant and who makes it

onto the waiting list, the time that

they wait for the procedure can

vary from a few months to over a

year, depending on different factors

including tissue compatibility.

After an available donor pancreas

has been matched to a suitable

recipient on the waiting list, the

pancreas is transferred to the Oxford

Facility from whichever hospital the

donor was based, within the UK. Islet

isolation is a multi-stage process,

which takes up to seven hours to

complete. Post-isolation, cells are

cultured for a minimum of 24 hours,

and release for transplantation can

only occur if the islets meet strict

production criteria, which includes

screening for overall viability, purity

and performing an islet count. To

count islets, scientists use a method

called islet equivalents (IEQ). This

is a standardised method of islet

counting, which takes into account

islet size. There needs to be a

minimum of 5,000 IEQ per kg of the

candidate's bodyweight for a first

transplant, so often in the region of

350,000 IEQ being required.

Professor Paul Johnson, left , Sarah Tutton centre, and Steve Hughes, the

unit's Facility Manager for many years before retiring earlier this year.

While the isolated islets are

carefully maintained, the identified

patient is brought into hospital and

prepped for the surgery and started

on anti-rejection drug therapy.

The transplant procedure does not

involve open surgery in the operating

department, but instead in the X-ray

department, a fine tube is inserted

under local anaesthetic into the main

vein going into the patient's liver (the

portal vein). The islets are then dripfed

into the recipient via gravity.

It is clearly a complex and skillful

procedure. One factor that has

huge influence on the outcome is

the knowledge and experience of

the team undertaking the process.

Professor Paul Johnson, Director of

the Human Islet Isolation Facility,

has been involved in islet isolation

for over 30 years and is responsible

for the development of the Isolation

Facility in Oxford. He explains, "We

use the liver as it is easily accessible

using minimally-invasive techniques

and the internal structure of the liver

is like a honeycomb, which means

that the islets get filtered by the

liver when they are infused into the

portal vein and quickly get trapped

in there. They then set up their new

Index

  1. Desang diabetes magazine, Making Carbs Count, Diabetes KIT, non-invasive glucose testing, OCDEM, Sig
  2. Desang diabetes, magazine diabetes information, Sue Marshall diabetes
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  9. Medtronic Guardian Connect CGM sensor for diabetes
  10. diabetes news, diabetes research news, diabetes information, diabetes kit, diabetes technology
  11. Diabetes UK
  12. ViaCyte being bought by Vertex to advance cure for type 1 diabetes.
  13. Medtronic MiniMed 780G System Automated for an easier way to stabilise glucose levels
  14. ViaCyte being bought by Vertex to advance cure for type 1 diabetes.
  15. JDRF UK, DigiBete solutions for children and young adults with Type 1 diabetes.
  16. Hallmark Care Homes, DUET Diabetes, National Advisory Panel on Care Home Guidance, Professor Alan Si
  17. Hallmark Care Homes, DUET Diabetes, National Advisory Panel on Care Home Guidance, Professor Alan Si
  18. Problems facing people with diabetes in high weather temperatures from Diabetes UK.
  19. Ascensia GloucoContro diabetes blood test result sharing software
  20. Sigi Insulin Management System, AMP Medical, Sigi insulin pump.
  21. Desang diabetes, Inside Diabetes guides
  22. donation to UK diabetes charities JDRF and Diabetes UK.
  23. donation to UK diabetes charities JDRF and Diabetes UK.
  24. OCDEM (Oxford Centre for Diabetes, Endocrinology and Metabolism and the Oxford DRWF Human Islet Isol
  25. OCDEM (Oxford Centre for Diabetes, Endocrinology and Metabolism and the Oxford DRWF Human Islet Isol
  26. OCDEM (Oxford Centre for Diabetes, Endocrinology and Metabolism and the Oxford DRWF Human Islet Isol
  27. Insulet Omnipod DASH insulin pump with insulin pods, podders, Omnipod DASH Personal Diabetes Manager
  28. OCDEM (Oxford Centre for Diabetes, Endocrinology and Metabolism and the Oxford DRWF Human Islet Isol
  29. DRWF wellness days and events
  30. Desang Diabetes Magazine, free diabetes magazine, living with diabetes
  31. Desang Diabetes Magazine, free diabetes magazine, living with diabetes
  32. diabetes food news, diabetic diet, counting carbohydrates
  33. Diabetes technology education from Diabetes Technology Network DTN
  34. diabetes food news, diabetic diet, counting carbohydrates
  35. Medtrum Touchcare Nano Patch Pump and CGM
  36. Page 0036
  37. Abbott Freestyle Libre 2, Flash Glucose Monitoring, FSL2
  38. Desang Diabetes Magazine, Making Carbs Count, carbohydrate counting for diabetes
  39. Desang Diabetes Magazine, Making Carbs Count, carbohydrate counting for diabetes
  40. Desang Diabetes Magazine, Making Carbs Count, carbohydrate counting for diabetes, anchovies and diab
  41. Desang diabetes kitbags, bag for diabetes kit
  42. Desang Diabetes Magazine, free diabetes magazine, living with diabetes

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