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Legislative Council - Fifty-First Parliament, Second Session (51-2)
2008-04-02 Daily Xml
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ISLET TRANSPLANTATION PROGRAM

The Hon. R.P. WORTLEY (15:32): I rise today to talk about the islet transplantation program in Australia, which was launched in 2006. It was funded by a grant of just over $30 million from the Australian Department of Health and Ageing, and it is managed by the Juvenile Diabetes Research Foundation (JDRF).

This exciting program supports both clinical and basic research into islet cell biology, immunology and transplantation protocols. Clinical research partners include Westmead Hospital in New South Wales, Queen Elizabeth Hospital in South Australia, and St Vincent's Institute of Medical Research in Victoria.

Mr President, you may very well ask: what is islet transplantation? Islet cells produce insulin, the very substance lacking in type 1 diabetics. Islet transplantation involves the placement of islet cells removed from a deceased organ donor into a patient. A donor pancreas is transferred to a specialised laboratory facility where a complicated process of mechanical and chemical separation isolates the islet cells from the whole organ.

The transplantation procedure is significantly less invasive than a whole organ transplant, with the cells being either infused through a catheter or inserted through a small incision in the abdomen. Once implanted, patient recovery time is fast, the beta cells in the islets begin to make and release insulin almost immediately, and the positive effects can be seen for around 10 to 15 years.

Using current protocols, one donor pancreas will supply about half a million islet cells. The number required for an insulin-free recipient is around 1 million, which means that most islet recipients require two transplants and two donors to be diabetes free. Currently, about only 10 per cent of islet donations make it to a successful transplant stage. Many techniques are being researched to help find a cure for diabetes; however, islet transplantation is one of the most promising.

Since its inception in 2006, the JDRF islet transplantation program (ITP) has undergone some exciting new developments, and in 2007 a very significant milestone was achieved: the first successful human islet transplant using the ITP protocols. This procedure took place in the clinical centre at Westmead Hospital in New South Wales, and donor cells were successfully transplanted into a young South Australian patient, helping her to produce her own insulin for the first time in 25 years. While she will require a second transplant to have a chance to be insulin independent, she has experienced a major reduction in the severe and unpredictable hypoglycaemic attacks she used to experience on a daily basis.

The launch of the basic research arm of the ITP was also a very significant milestone. As islets sourced from donors can never be the answer to curing diabetes, research into alternate sources of insulin-producing cells is vital. Basic and clinical research support each other as clinical research tests what has been developed in the laboratory and feeds information back to the lab to encourage refinement and advancement of techniques.

The initiation of the ITP basic research program, with an emphasis on immune tolerance, will help to provide solutions to the challenges patients undergoing clinical islet transplants currently face. It also marks a new era of research collaboration, with scientists from traditional fields working together through the ITP. Future plans for the ITP are: to successfully transplant more patients using approved protocols; perfect the use of alternate enzymes for islet isolations; increase patient recruitment and the number of suitable and active recipients; raise awareness and promote the program through public forums; and commence the recruitment of transplanted patients into outcome studies that will feed back into both basic and clinical programs.

I am sure members of this chamber are excited by the recent developments I have talked about today. I look forward to informing this chamber of ITP developments in the future.

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