Islet of Langerhans transplantation is spreading in France

Islet of Langerhans transplantation is spreading in France

pancreatic gland anatomical model

Pancreatic islet transplantation is entering a new stage after two decades of testing. The health authorities have indeed recently authorized it. This new treatment protocol is revolutionizing the lives of people living with type 1 diabetes. Some French hospitals have already been granted approval to use it.

In 1999, the first therapeutic trials of pancreatic islet transplantation were launched in Canada. They then chained themselves to the Old Continent for the next twenty years. In 2020, the High Authority for Health approved the use of this treatment for certain categories of chronically unstable patients.

Since then, this one, long awaited by patients suffering from a insulin-dependent diabetes very unstable, develops in France. The first execution of such a practice in routine care in the country took place last December at the CHRU Lille. That of Strasbourg then took the example of the hospital to achieve it on October 24, 2022.

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Many hospitals want to perform the operation

The Regional Health Agencies (ARS) have also issued authorization to other establishments wishing to carry out this type of operation. A few hospital institutes in Montpellier, Grenoble and Paris have obtained them after consulting the Biomedicine Agency. Centers in Nantes and Toulouse have also applied for approval. The deputy director of this public institution, Professor Michel Tsimaratos, explains that approvals are subject to:

  • Quality conditions for patients;
  • Security criteria.

The manager indicates that the expertise is now held by those who have already practiced this transplantation on an experimental basis. However, it is accessible to several laboratories, he points out. The researcher adds that with islet transplantation:

[…] The therapeutic arsenal at the service of patients is enriched, and this is undoubtedly what should be remembered.

For information, the use of this treatment as part of routine care is reimbursed by health insurance.

To deal with possible remainders in charge, the possession of a mutual health insurance is however recommended.

According to a professor of diabetology at the University Hospital of Strasbourg, Laurence Kessler, the authorization of this practice represents:

  • For doctors, immense recognition and the result of a very high-level multidisciplinary clinical study;
  • On the patient side, a huge step forward.

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Various types of patients can benefit from the treatment

In 1988, the diabetes specialist was already preparing a master’s degree on rat pancreatic islets. She thus declares that at the scale of a career, great satisfaction is provided by:

  • Follow-up of studies in animal subjects, then in humans;
  • The arrival to routine care.

The researcher reveals that hundreds of insulin-dependent diabetics undergo pancreatic islet transplantation every year. However, this number represents a very small proportion of the 370,000 patients identified by the French Federation of Diabetics, she adds. Laurence Kessler underlines that this figure constitutes a minority, but it turns out to be crucial, because:

[…] These are patients for whom we have no therapeutic alternative. And we are only at the beginning: this treatment may be indicated for other patients who have failed treatment, in the event of pancreatic disease or cystic fibrosis.

Laurence Kessler

This operation is carried out by installing islets of Langerhans in the patient’s liver. These refer to pancreatic cells responsible for the production of insulin. They come from a donor without diabetes whose brain functions have stopped.

Among the first French people to have undergone such an intervention outside of an experimental project is Valerie Rodriguez. The patient said that since then, her blood sugar has stabilized and her body is much less tired. This care protocol is great, she concluded.

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