A Japanese woman is free of the symptoms of diabetes after receiving cells from her mother's pancreas in the first transplant from a living donor, it emerged on Monday.
The woman, 27, who had had insulin-dependent diabetes since she was 15, was given islet cells from her 56-year-old mother's pancreas.
Fears that the donor might become diabetic because of the loss of a substantial number of islet cells appear unfounded.
The operation will be of interest to the millions of people around the world who suffer from diabetes.
Islet cells produce insulin, a natural hormone which turns glucose in the blood into energy.
Those whose cells do not produce enough insulin have to inject themselves with it daily.
Small numbers of people with diabetes have had islet-cell transplants from cadavers, but the huge number of cells needed for each operation has severely restricted the possibilities.
DEPENDENCY FREE
A paper from Shinichi Matsumoto and his colleagues at Kyoto University, published online by The Lancet medical journal, reveals that the cells from half the mother's pancreas were sufficient to free the recipient of her insulin dependency within 22 days.
She has now been insulin-free for two months and her mother has suffered no complications. the paper said.
The daughter had severe type 1 diabetes and was having "hypos" -- hypoglycaemic attacks in which she lost consciousness -- every two days.
There are cultural sensitivities around the use of pancreatic islet cells from dead donors in Japan, so her mother volunteered.
The researchers say that the outcome was as good as that achieved with the cells of two or more whole pancreases from dead donors. They think this may be due to the improved potency of islet cells from a living donor.
FIVE YEARS
The transplant could last for five years, they say, and even if the woman needs insulin injections in the future, the scientists believe she will be free of the "hypos" that endanger her life.
In a commentary, Stephanie Amiel from King's College, London, warns that these are early days.
"Islet transplantation is not yet a perfect technique," she said. "Insulin independence is by no means certain."
The drugs needed to stop the body rejecting the transplanted cells are toxic and the long-term survival potential of the cells is unclear.
But up to 25 percent of people with diabetes suffer from recurrent severe hypoglycemia and probably 15 percent of those cannot be improved using conventional therapy.
While the use of a live donor, with its inherent dangers, probably cannot be justified in a society where cadavers can be used, diabetics would be watching the success of the Japanese research closely, Amiel said.
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