PLYMOUTH MEETING, PA--Islet cell transplantation may eventually prove to be an effective treatment option for certain Type 1 diabetes patients, according to a recent systematic review of published studies and other data. This procedure involves transplanting whole islet of Langerhans from the pancreas obtained from deceased donors (i.e., cadaveric donors). The underlying theory behind this minimally invasive procedure is that transplantation would enable the recipient to begin creating his or her own insulin again to immediately and physiologically respond to blood glucose levels.

ECRI, an independent, nonprofit health services research agency, systematically searched for and assessed all relevant clinical literature on this procedure. ECRI's findings suggest that some patients who receive islet cell transplantation no longer require insulin injections or infusions and some no longer suffer from dangerous episodes of hypoglycemia. Hypoglycemia can occur with intensive management of diabetes and the required insulin injections/infusions. Candidates for islet transplantation, which is available only at highly selective centers conducting research on the procedure, include individuals with type 1 diabetes of at least five years' duration, hypoglycemia unawareness, recent hypoglycemia reaction, progressive secondary complications of diabetes, or failure of intensive insulin management.

ECRI's Windows on Medical Technology evidence report, "Islet Cell Transplantation for the Treatment of Type 1 Diabetes," examined an evidence base of seven uncontrolled case series. ECRI examined primary benefits, adverse events, and improvement of secondary complications of diabetes with islet cell transplantation.
ECRI performed a meta-analysis of study results to estimate that, one year after completion of islet cell transplantation procedures, 57% of patients no longer required insulin injections. The available evidence was insufficient to permit evidence-based conclusions about whether islet cell transplantation improves secondary complications of diabetes and no comparative data were available on intensive insulin therapy relative to islet cell transplantation.

ECRI's Health Technology Assessment Information Service(HTAIS) provides broad access to technology assessment information and research results to provide objective information to organizations and government agencies that make decisions about the use of medical devices, drugs, procedures, and healthcare services. ECRI evaluates technologies along the continuum of evidence from research and development into wide utilization. As evidence accumulates about healthcare technologies and services, ECRI analyzes the available data to produce various types of evidence reports. ECRI's Windows on Medical Technology reports are systematic reviews of technologies in wide use that have a considerable body of evidence, but still have unresolved key clinical questions about their optimal use. Using meta-analytic techniques, ECRI pools data from many studies to answer questions that could not be resolved by looking at individual studies. ECRI's HTAIS memberships give hospitals, health systems, health plans, and government agencies the information they need to make informed and strategic decisions about the healthcare technologies and services in use today and those they need to plan for tomorrow.

HTAIS members receive Windows on Medical Technology reports as part of their custom membership benefits; nonmembers may purchase copies of these reports separately. To purchase, please contact Don Cummins at (610) 825-6000, ext. 5170.

For information about HTAIS, visit www.ecri.org, or contact ECRI by telephone at (610) 825-6000, ext. 5170; by fax at (610) 834-1275; or by mail at 5200 Butler Pike, Plymouth Meeting, PA 19462-1298, USA.

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