Why Doctors Are Hesitant to Do Pancreas Transplants for Diabetes Patients

In fact, because it is a considerably precarious and unreliable procedure, it’s only performed on patients with extreme hypoglycemia unawareness, said Dyer.

Hypoglycemia unawareness is a condition in which a patient no longer experiences the helpful warning signs of an oncoming low blood sugar.

Being unable to feel those symptoms (such as lightheadedness, hunger, dizziness, trembling, and confusion) is dangerous because it means the patient can’t treat the problem by eating a fast-acting source of carbohydrate to prevent blood sugar from dropping to severely low levels that can result in seizure or death.

Patients with hypoglycemia unawareness have been deemed eligible for a transplant when it’s apparent that their unpredictable and severe low blood sugars are affecting their ability to function safely on a daily basis.

The challenges of a transplant

But being eligible for an islet cell transplant doesn’t mean life is going to become effortlessly free of diabetes.

Instead, it’s simply a trade for a new variety of challenges.

“A successful islet cell transplant actually requires multiple cadavers to collect at least 40 islet cells for one patient’s transplant,” says Dyer.

Simply collecting useful islet cells is complicated because, while they are being donated by cadavers, the islet cells of a cadaver are being rapidly destroyed after that person’s death.

“It’s estimated by the NIH [National Institutes of Health] that only slightly more than half of decedent donors, which are rare enough already, are viable for islet transplantation,” explains Reddit user Yoojine in a recent, lengthy discussion on the site about islet cell transplants. “Even if you get a good donor, islet recovery rates aren’t perfect and you usually get maybe half of the islets available, sometimes far less. This then necessitates pooling of islets from multiple pancreata (the fancy scientific plural of pancreas), which currently averages out to, I believe, two good donor pancreata per recipient. It also makes living donation of islets suboptimal, since a single donor is unlikely to provide enough viable islets.”

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