The Edmonton Protocol

Before the Edmonton protocol was developed, researchers used steroid-based immunosuppressant regimens. Many of these drugs damaged the insulin-producing cells or made recipients insulin resistant, which made more work for the new islets.

In the late 1990s, Dr. James Shapiro and colleagues at the University of Alberta, in Edmonton, Canada, introduced the following changes:

• They shortened the time between harvesting the pancreas from a donor and the transplant procedure.
• They infused many more islets than had been typically used in the past.
• They used an immunosuppressive protocol that included sirolimus, low-dose tacrolimus, and daclizumab. No glucocorticoids were given.

The Edmonton protocol has been adapted by islet transplant centers worldwide. Over 500 islet transplant procedures have been done with some variant of this protocol.