Italian Surgical Team Transplants Islet Cells Using Diabetes Research Institute Technique

A surgical team in Milan, Italy, has transplanted insulin-producing islet cells in a patient with diabetes, using an innovative technique developed at the University of Miami Miller School of Medicine’s Diabetes Research Institute (DRI). On November 17, Dr. Federico Bertuzzi, who heads the Islet Transplant Program at Ospedale Niguarda Ca’ Granda, a public hospital in Milan, successfully completed the first such transplant in the world outside Miami.

“We believe this new islet transplantation procedure using a bioactive scaffold developed at the University of Miami has great potential to improve outcomes for diabetes patients around the world,” said Camillo Ricordi, M.D., Director of the DRI and the Stacy Joy Goodman Professor of Surgery, Distinguished Professor of Medicine, and professor of biomedical engineering, and microbiology and immunology. Dr. Ricordi also serves as director of the DRI’s Cell Transplant Center.

Ricordi assisted the Milan team during the surgery using the DRI’s telescience platform.

“On the day of the transplant, 400,000 islets were infused in the biologic scaffold, and the patient was able to move to a minimal insulin therapy on the second day after the surgery,” said Ricordi. “We are all very excited for this first DRI Federation European attempt, and plan to provide support for other academic medical centers in implementing this procedure.”

The first two Miller School patients were participants in an FDA-approved Phase I/II study focusing on transplanting islet cells on the surface of the omentum, a highly vascularized tissue covering abdominal organs, using a biologically active scaffold technique.

“Our team is building on decades of progress in clinical islet transplantation toward the development of the DRI BioHub, a bioengineered mini organ that will mimic the native pancreas to restore natural insulin production in people with type 1 diabetes,” said Ricordi.

Using a biodegradable scaffold implanted on the surface of the omentum minimizes the inflammatory reaction that is normally observed when islets are implanted in the liver or in other sites with immediate contact to the blood, said Ricordi. Avoidance of inflammation has been shown to be important to minimize harm to the newly transplanted islets.

The biodegradable scaffold, one of the platforms for a DRI BioHub, is a combination of a patient’s own blood plasma and thrombin, a commonly used, clinical-grade enzyme. When combined, these substances create a gel-like material that sticks to the omentum and holds the islets in place. The omentum is then folded over and around the biodegradable scaffold mixture. Over time, the body will absorb the gel, leaving the islets intact, while new blood vessels are formed to provide critical oxygen and other nutrients that support the cells’ survival.

In type 1 diabetes, the insulin-producing islet cells of the pancreas have been mistakenly destroyed by the immune system, requiring patients to manage their blood sugar levels through a daily regimen of insulin therapy. Islet transplantation has allowed some patients to live without the need for insulin injections after receiving a transplant of donor cells. Some patients who have received islet transplants at the DRI have been insulin-independent for more than a decade.

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