Islet transplantation is a relatively new procedure used in people with difficult to control
Type 1 diabetes. Insulin producing cells (islets) are isolated from a pancreas donated by the
next of kin of a person who is brain dead. After the cells are prepared, the islets are
transplanted into the recipient's liver and produce insulin. Patients who receive an islet
transplant take medication that suppresses their immune system and prevent rejection of the
islet tissue.
The investigators have also learned that there is general inflammation at the time of the
transplant that is not fully controlled with our standard medications. The investigators
believe this inflammation may cause some islet cell death around the time of transplant. Due
to this islet death around the time of transplant, most recipients need 2 or 3 separate
transplant procedures.
The investigators are studying the use of Alpha-1 Antitrypsin (AAT) in islet transplant to
decrease the amount of cell death caused by general inflammation. In this study, the
investigators hope to decrease the need for more than one transplant procedure by controlling
inflammation, before and after transplant, with Alpha-1 Antitrypsin (Aralast NP).
Alpha-1 Antitrypsin is a protein made in healthy humans that helps to prevent tissue damage
during times of inflammation. Alpha-1 Antitrypsin is obtained from healthy plasma donors.
There have been studies in Islet Transplant in monkeys using this medication and it has shown
to protect the islets from inflammation.
This study involves using Alpha-1 Antitrypsin in addition to our current Standard of Care
medications used in Islet Transplant.