Type 1 Diabetes Mellitus Clinical Trial
Official title:
Open Study to Evaluate Safety and Efficacy of Allogenic Islet Transplantation Using Islets Coated With Immobilised Heparin
In this study the islets will be surface modified to carry immobilised heparin (Corline Heparin Conjugate) prior to transplantation. The primary objective is to investigate safety and efficacy of allogeneic islet transplantation using islets coated with immobilised heparin. The modification with heparin has been shown to protect the islets from being attacked by the immediate defence systems in blood (coagulation and inflammation), so that a larger portion of the islets will survive the initial phase and engraft. Evaluation will be based on metabolic and blood chemistry parameters.
Transplantation of islets of Langerhans isolated from donated organs is a promising therapy
for diabetes type 1. The results so far have, however, not met with the expectations due to
relatively low efficiency. Even in situations where the patients have become insulin-free, it
has been estimated that the transplanted islet mass is less than 25% of the islet mass of a
healthy individual, which in many cases has required repeated use of insulin injections. The
islets are transferred to the patient by an infusion drop to the liver via the portal vein.
Researches within the Nordic Network for Clinical Islet Transplantation have in a series of
publications shown that the islets are subject to a violent immunological reaction that is
non-specific with regard to the individual patient (IBMIR) during the initial contact with
blood (Moberg et al, Lancet 2002, among several). The IBMIR reaction is in the earliest phase
mediated by coagulation and complement reactions.
In this study the islets will be surface modified to carry immobilised heparin (Corline
Heparin Conjugate) prior to transplantation. The primary objective is to protect the islets
from being attacked by IBMIR so that a larger portion of the islets will survive the initial
phase and engraft. In a paper published by the research group (Cabric et. al., Diabetes, May
2007), the beneficial effects of immobilised heparin on the islets to counteract IBMIR were
shown by experiments at the lab bench and in experimental animals.
The evaluation of the transplantations in this study will be based on metabolic and blood
chemistry parameters, similar to the evaluations of other transplanted patients within the
Nordic Network.
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