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"A little bit of normalcy" for those with diabetes

Islet transplants may eliminate the need for insulin shots

By Dana Goldman

Story Photo

Emory transplant surgeon Nicole Turgeon recently transplanted pancreatic islet cells into patient Julie Allred's liver. The cells produce insulin, reducing or eliminating the need for insulin shots. Photography by Jack Kearse

Julie Allred, a pediatric nurse from North Carolina, wanted to stay awake. No matter that she was about to undergo an experimental procedure to provide her with insulin-producing cells from an organ donor. No matter that the lifelong diabetic had driven the four hours from her home to Emory on a moment's notice. No matter that she had spent the past two days in a hospital bed receiving medications to suppress her immune system.

Emory transplant surgeon Nicole Turgeon asked Allred why she wanted to undergo this procedure. The answer was simple, she explained. "I said, 'You're about to change my life. Not everyone has this opportunity. I want to see this.'"

After all, for Allred, then 42, the islet transplant was a chance at a life in which her blood sugar didn't drop precipitously low as a result of type 1 diabetes and cause her to lose consciousness. In the years preceding the transplant, those low blood sugar levels had significantly affected Allred's moods, relationships, and ability to think clearly. She remembers becoming combative when someone tried to check her blood sugar. "Somebody had to watch me constantly."

Now all that's changed. In July 2011—and again on leap day in 2012—Allred stayed awake as Emory interventional radiologist Kevin Kim accessed a vein in her liver through which Turgeon transplanted pancreatic islet cells. As part of a multi-year national research study on the procedure, insulin-producing cells (islets) are harvested from an organ donor's pancreas and inserted into the recipient's liver. Those transplanted cells then produce insulin, reducing or eliminating the need for insulin shots (at least temporarily) and helping the body regain the ability to maintain steady, healthy blood sugar levels. 

Soon after the first islet transplant, the episodes of life-threatening low blood sugar levels stopped for Allred. "I didn't know how bad I felt until I felt better," she says. "It's made me aware of a lot of things that you take for granted each day."

Allred doesn't, however, take for granted that she's one of just 18 patients who have undergone the islet transplant procedure at Emory, the only such transplant center in Georgia. "If I get six months or a year more—and that's one of the unknowns—I'm so lucky to be one of those few people to have that little bit of normalcy for my life and family," she says. 

Turgeon, who has spearheaded Emory's participation in the nationwide study, says that Allred's experience is similar to that of other study participants. "These patients are the most grateful patients I have worked with," she says. "Most of them say they can't remember the last time they felt so good and didn't have to worry about high or low blood sugars. They often say it is life-changing."

Her hope is that the study will pave the way for more islet transplants and a better quality of life for those living with diabetes. That's a hope that her patient shares. "A cure is closer than it's ever been," Allred says. —Dana Goldman

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