ISMETT, first pancreatic islets transplant for the more serious cases of diabetes

A transplant of pancreatic islets – clusters of endocrine cells in the pancreas that contain insulin-producing cells – was performed at IRCCS ISMETT in Palermo last week on a 52-year-old woman from Puglia suffering from a severe form of diabetes 1 (a.k.a. juvenile diabetes), with reduced sensibility due to hypoglycemia. The woman was transferred to ISMETT in the middle of the night thanks to the joint efforts of the regional transplant centers of Sicily and Puglia. The procedure was performed in Palermo with support from Miami, using the modern Telescience technology.

This was by all means a most fruitful collaboration between ISMETT, Ri.MED Foundation, and the Diabetes Research Institute (DRI) at the University of Miami. Led by Director Camillo Ricordi, M.D., DRI is the center with the largest experience in the world in the field of pancreatic cells transplantation.

This transplant is one of the few ever performed in Italy, and the second in Southern Italy. Currently only a few Italian centers are performing this procedure, and are almost all based in Northern Italy. The difficulty of this therapy is mainly linked to the processing of the pancreatic cells, and to the availability of sterile laboratories equipped for cell processing.

The intervention, which followed the pancreas procurement from a deceased donor performed by the ISMETT team, consisted of two distinct phases. The first involved separating and extracting the insulin-producing cells from the donor’s pancreas, and purifying them. At this point, thanks to the so-called “Ricordi Method”, the pancreas cells that produce insulin are isolated from the procured graft with a process that lasts several hours. The cell processing was done by a joint team of doctors and biologists of ISMETT and Ri.MED Foundation. The procedure was coordinated in Palermo by Dr. Anna Casu, Director of the ISMETT Diabetology Unit. During the cell processing, the patient preparation, the actual transplant, and the following days, Dr. Casu was in contact with Dr. Ricordi, the scientist who invented the method that made possible cell transplantation.

After the cell processing and isolation, the second phase involved the infusion of the cells into the patient. The islets were infused through the vein that carries blood to the liver, to allow the cell colonization in the organ of the patient. This second step was performed at ISMETT’s Radiology Department.

“Thanks to Telescience, a technology similar to Telemedicine, DRI in Miami is in constant contact with all centers producing pancreatic islets”, said Dr. Camillo Ricordi, “including those, like ISMETT, that are members of the DRI Federation, a global alliance of centers collaborating with no barriers to cure diabetes in the fastest and most efficient way possible.”

The patient is well and has already been discharged. “Her clinical conditions are good”, said Dr. Anna Casu. “She will remain a few weeks in Palermo for routine follow-up, and then return home in Puglia. This method has several advantages including avoiding major surgery such is a pancreas transplant, reducing the patient’s hospital stay, and resuming a good quality of life a few days after the operation.”