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News

Implantation of Patient’s Own Islet Cells at Dresden University Hospital

The Center for Islet Cell Transplantation at Dresden University Hospital has saved a 43-year-old work accident victim from developing diabetes: A team of doctors was able to salvage insulin-producing islet cells from the injured pancreas of the patient, process them and implant them in the patient’s liver. The medical team consisted of visceral surgeons and diabetologists, some of whom are members in the DZD.

 

The multidisciplinary team, utilizing expertise only available at Dresden University Hospital, was thus the first to transplant own islet cells from a patient’s injured pancreas. Usually only seriously ill diabetic patients are transplanted a donor pancreas or isolated pancreatic islet cells from a deceased person. Transplantation in diabetic patients is only considered if they suffer from extremely fluctuating blood glucose levels.
After an initial emergency operation in a hospital in the Dresden region on February 7, 2013, the patient was transferred the same evening to Dresden University Hospital for surgical treatment of the pancreas, which had been torn in a blunt impact injury, and the injured abdominal vessels. But the abdominal surgeon Professor Robert Grützmann could not save the organ completely: The rupture was so close to the opening to the small intestine that it could not be pieced together again. The posterior section of the pancreas was still intact, however, so that there was a good chance that the Langerhans’ islets – the islet cells that produce insulin – could be removed.

Preparation overnight
Already during the operation Professor Grützmann called on Dr. Barbara Ludwig of the Department of Internal Medicine III, a member of the DZD, to process the islet cells for the transplantation. The internist and diabetologist is specialized in the preparation of islet cells and in recent years has performed this task for around 20 transplant patients. Dr. Ludwig took over the intact section of the pancreas that had been removed. The same night, in a complex process, the islet cells were extracted from the pancreas and prepared for transplantation. Dr. Ludwig was able to isolate about 200,000 living insulin-producing cells from the intact section of the pancreas – a normal pancreas contains about one million of these pancreatic islets.
The next morning, the isolated cells had aggregated to become islets – in this form they are up to half a millimeter in diameter and are visible to the naked eye – and were transferred to the liver of the patient: Professor Grützmann and Dr. Ludwig injected the cells into the central portal vein, which supplies the liver with blood. In a procedure similar to other kinds of infusions, the surgical team infused the cells into the organ within a half hour. In the meantime the hospital doctors have been able to confirm that the patient is again producing his own insulin – the islet cells appear to have colonized in the organ.

Diabetology in Dresden in Focus
Recent years have seen great advancements in basic research and patient care in the field of diabetology in Dresden. The beginning was made by Professor Michele Solimena, who came from Yale University, New Haven, CT, USA and established the research area Experimental Diabetology. He built up and heads the Paul Langerhans Institute Dresden, which is part of the German Center for Diabetes Research. In addition, since 2004 Professor Stefan Bornstein, an internationally renowned diabetologist, has headed Dresden University Hospital’s Department of Internal Medicine III. The hospital offers individual treatment strategies and is one of the leading centers in Europe for the treatment of type 1 and type 2 diabetes and its complications – such as diabetic foot syndrome, vascular disease and renal failure. The University Hospital is also a pioneer in diabetes prevention. The Department of Internal Medicine III with its polyclinic was the first to have a professorship for the prevention and care of diabetes. For people with elevated diabetes risk the department offers special programs and treatments that aim to promote early detection or possible prevention of the disease.