Dr Rainer Gruessner was appointed chair of the Department of Surgery at the University of Arizona’s College of Medicine in Tucson. He is an authority on transplant options for patients with diabetes mellitus.
“Diabetes is usually considered a disease with a low quality of life,” he says. “But it really is a very crippling, life threatening and life-shortening disease.” Dr Rainer Gruessner states that diabetes is the most common cause of leg amputations, blindness, kidney disease, and other morbidities in the United States. Diabetes affects about ten percent of the population, over thirty million people.
“We have several different options to treat patients with diabetes through transplantation,” Dr Rainer Gruessner says. “The first one is kidney transplantation. Most of the patients with end-stage kidney disease, about forty to fifty percent, have non-functioning kidneys as a result of diabetes. If we do a kidney transplant, we correct the symptom of end-stage kidney disease and achieve dialysis-independence.” The trouble with this option, Gruessner continues, is that “a kidney transplant doesn’t do anything about the diabetes, and there is a good chance the diabetes will recur in the transplanted kidney later on and destroy it.”
To cure diabetes, Dr Rainer Gruessner says, surgeons have to transplant the insulin-producing cells. “We can do that through two mechanisms,” he says. “The first option is to transplant the entire pancreas and the results are very good: more than 4 in 5 patients after a successful pancreas transplant do not require any insulin and the progression of secondary diabetic complications is halted or reversed. Some patients have been off insulin for over 25 years after a successful pancreas transplant.”
Dr Rainer Gruessner says the other option is to transplant only the cells that produce insulin. “However, the results of islet transplantation trail those of pancreas transplantation and islet transplantation is currently not covered by Medicaire/Medicaid or private insurance companies.”