By Professor Paul Johnson, MBChB M
D FRCS
Director of Oxford Islet Transplant Programme, Professor of Paediatric Surgery, University of Oxford and member of the DRWF Research Advisory Board
From 12th -15th October 2009, experts from around the world gathered together on the Venice Lido for a unique joint meeting between the International Pancreas and Islet Transplant Association (IPITA) and the International Xenotransplantation Association (IXA).
The main emphasis of this five day meeting was on finding a cure for diabetes by using different types of beta-cell replacement, for which DRWF has given considerable funding.
Meeting in the Palazzo del Casinò of the Venice Congress Center (the same building that a couple of months previously had housed the famous Venice Film Festival), over 400 clinicians and scientists listened to invited lectures, state-of the art symposia, and shorter oral presentations, each highlighting the very latest data in these cutting-edge fields of medicine.
DRWF was represented by co-founders and trustee John and Diane Alahouzos and charity Chief Executive, Sarah Bone. Many of the presentations during the week were given by DRWF funded clinicians and scientists.
The meeting started with a half-day symposium on the ‘current challenges of human islet isolation’. This is a critical issue that needs addressing in order to enable pancreatic islet transplantation to become more widely available. The symposium was chaired by Professor Bernhard Hering (Minneapolis, USA), and by Professor Paul Johnson (Oxford, UK), both of whose research programmes are supported by grants from DRWF.
One of the struggles for many years has been the variability of the commercially available enzyme (collagenase) used for islet separation. It was promising therefore, to have different pharmaceutical companies present their latest data on new enzymes that they are developing. This was balanced by presentations by a number of leading investigators from Europe and North America researching novel approaches to optimise this complex procedure.
The symposium was followed by the official Welcome Reception, which was sponsored by DRWF. This was an opportunity for the Local Organising Committee to introduce delegates to the meeting. John Alahouzos gave an excellent welcome speech and an overview of the work of DRWF and the desperate need to find a cure for diabetes.
Highlights of the next few days included sessions on pancreas donation, clinical pancreas transplantation, clinical islet transplantation, novel immunosuppressive protocols (anti-rejection drugs), and stem-cell biology. It was encouraging to hear the most recent updates of the clinical outcomes of islet (cell) transplantation from different centres worldwide, with the newer islet protocols achieving comparable success rates to the more established whole pancreas transplants in selected patients. Whole pancreas transplantation continues to be an excellent treatment option for those individuals requiring a simultaneous kidney transplant.
A major emphasis of the week was exploring alternative sources of islets for transplantation in order to overcome the significant shortage of human donor pancreases compared with the number of people requiring this treatment. By combining with IXA, the meeting was able to bring together the leading groups investigating the use of xeno-transplants (animal tissue). The advances in this field have been considerable.
In particular, the Spring Point Project (a not for profit organisation working with the Schultz Diabetes Institute, Minneapolis) presented outstanding data confirming that clinical trials of islet xeno-transplantation will be commencing in 2010. An important emphasis was also made on the need for tight ethical controls and careful safety precautions for this novel technology.
One of the most memorable parts of the meeting was the presentation of the first Derek Gray Travelling Fellowships to Dr Barbara Ludwig (Lieden). Derek Gray has been one of the pioneers of islet transplantation over the past 30 years, but sadly has been affected by a severe chronic illness over recent years. This new named Fellowship is an acknowledgement and tribute from his peers within IPITA of his major contribution to the islet field.
Venice as a meeting venue proved to be highly successful, with the interesting paradox between the immense history of the city all around, and the meeting showcasing some of the most cutting-edge aspects of modern science. The Local Organising Committee chaired by Emanuele Cozzi (Padua), with the Conference Organisers (Key Congress) worked tirelessly to ensure that the meeting was a success. We are very grateful to them.
The next meeting of IPITA is being held in Prague in 2011. In the meantime, all the delegates present in Venice have been motivated to continue the important work to find a cure for this debilitating disease.
Islet cell transplantation and DRWF funding
(OCDEM), at the Churchill Hospital, is one of just six English hospitals to offer islet cell transplantation.
Since 1 April 2008, islet cell transplants have been available as a treatment, to selected people with Type 1 diabetes.
Patients receiving islet cell transplantation receive insulin producing islets, taken from a donated human pancreas. Islets are harvested from the donor pancreas in the state-of-the-art DRWF Islet Isolation Facility at OCDEM which was opened in 2006 with a £1.2 million grant from the Diabetes Research and Wellness Foundation (DRWF).
DRWF in the USA, has funded a Chair in Diabetes and Islet Transplantation in Boston and funded a major programme in developing alternative sources of islets in Minneapolis.