Type 1 diabetes happens when insulin-producing cells in the pancreas are destroyed by the immune system. The regions of the pancreas which contain insulin-producing cells are called islets.
In islet transplants, doctors can transplant islet cells from donors into people with type 1 diabetes to replace some of the cells that have been destroyed.
Islet transplants can be life-changing, and even life-saving. They're available through the NHS for adults with type 1 diabetes who have lost their hypo awareness and have severe hypos. And that's in large part thanks to the research we've funded in this area.
How do islet transplants work?
Islet transplants involve extracting islets from a donated pancreas and implanting them into the liver of someone with type 1 diabetes. It's a minor procedure that can be done under local anesthetic. Usually people will need two separate transplants to see the benefit.
Islets transplants help people with type 1 diabetes to produce their own insulin again. This can lead to massive benefits, like fewer severe hypos, regaining hypo awareness, more stable blood sugar levels and a better quality of life.
Some people are able to stop taking insulin for a period after a transplant (usually between one to five years), but eventually will need to start injecting or pumping insulin again. This is because the donated cells can't survive in the longer term.
People who get a transplant will need to take anti-rejection drugs, also called immunosuppressants, to prevent their immune system from destroying the donated cells.
We made it happen
Our scientists, led by Dr Roger James and Dr Stephen Lake, developed a way to collect islets for transplant in 1989, allowing the first ever transplant to take place in Canada. The method they pioneered is still regarded as the gold standard today.
Soon after we launched the UK Islet Transplant Consortium, which brought together leading researchers around the country to ensure islet transplants would become available in the UK. Off the back of this, our supporters raised £650,000 which paid for the UK’s first 15 islet transplants from 2005.
By 2008, islet transplants were made available on the NHS for adults with type 1 diabetes who have severe hypos and a lack of hypo awareness.
"Before my transplant, I was also getting no signs of hypos. This was another reason my doctors decided to try the transplant. Since I have had the transplants, I'm starting to get some signs of hypos back. I'm more prepared when they happen now, it is improving so we're getting there slowly."
Bruce had an islet transplant in 2014. Read Bruce's story to find out more.
But there's more to do
Islet transplants aren't perfect yet, so we're continuing to support research right now to make them even better.
With our funding, Professor Shareen Forbes and her team at the University of Edinburgh are pioneering a new transplantation technique that helps islets to thrive and survive when transplanted into the liver. They've shown that in mice transplanting islet cells alongside proteins that stimulate cell growth in the liver helped to reduce the number of islets needed and helped them work better to manage blood sugar levels.
If in the future clinical trials show that this approach is safe and effective in people, it could reduce the number of donor islets needed for each transplant, meaning many more people with type 1 diabetes could benefit from the treatment.