A pancreas is a terrible thing to waste, yet hundreds of the donated organs are thrown out each year. That may change: Scientists now say they've found a way to recycle the used organs into new pancreases.
A healthy pancreas helps its owner digest his or her food, and releases the chemicals that help regulate blood sugar. Unfortunately, many people don’t have healthy pancreases. More than a million Americans have been diagnosed with type 1 diabetes, a disease caused by a dysfunctional pancreas. But only a few of those people will get a new pancreas: only three out of every 10,000 people with type 1 diabetes will ever get a pancreas or pancreas cell transplant.
There are a few reasons for this. First, pancreases (or “pancreata,” to use the plural preferred by scientists) don’t grow on trees. The pool of donated pancreata is pretty small to begin with. Then there’s the fact that about 25 percent of these organs will be deemed defective and discarded. Lastly, organ transplant is currently a grueling and risky process. There’s a very real possibility that a person’s body will reject the new organ. To make matters worse, the drugs used to prevent that rejection are really hard on the body, and they have to be taken for the rest of a person’s life.
Two of these challenges—wasting donated organs and a lifetime of unpleasant drugs—may be close to solutions. Scientists from Wake Forest University Baptist Medical Center and elsewhere believe they’ve found a way to recycle donated pancreata that may also cut down on the need for rejection-prevention medication. Their findings were recently published in the Annals of Surgery.
The recycling begins with a process called decellularization, which literally removes an organ’s cells. The organs are washed with special mild detergents that strip out the cells while leaving the organ’s framework, or extracellular matrix, intact. Into this scaffolding, the researchers say, they can insert cells from the transplant patient. The result is a brand-new pancreas made largely from the patient’s own body, which eliminates the risk that the transplant will be rejected, thereby eliminating the need for anti-rejection drugs.
At this point, it’s all fairly theoretical. The researchers started with 25 real human pancreases, but the finished products were not implanted into people. The researchers did, however, run tests on the new pancreas structures to find out how they would affect a live immune system. Unlike organs taken directly from donors, the recycled pancreata cells seemed to have a calming effect on the immune system, which made it far more likely that they wouldn’t be rejected.
Decellularization itself is not a new concept, but these researchers are among the first to show the process could be used to create whole human organs.
"The early results are encouraging," lead author Giuseppe Orlando said in a press release. "We believe this research represents the first critical step toward a fully human-derived artificial pancreas."