It takes eight to ten hours to prepare the islets. The donated pancreas is inspected and a tube is placed in the pancreatic duct. An infusion of enzymes is flushed into the pancreas, which starts to break down the tissue so the islet tissue is freed from the rest of the pancreatic tissue.
Once the pancreas is well flushed, it's cut into small pieces and put in a special container with steel marbles. The container is shaken, and the enzyme solution is flushed through the container.
Samples are taken frequently. Once the islet tissue is seen to be separating from the rest of the tissue, the infusion of enzymes is stopped. The tissue is separated, and the islet tissue is removed and washed. The islets are checked to be sure they are not damaged and counted. If the number or quality of islets is not satisfactory, the transplant is cancelled.
Procedure
Islet transplantation is a usually done in the radiology department. It takes 30 minutes to 2 hours.
The recipient receives some sedation but remains conscious. A local anesthetic is injected where the catheter will go in, on the right side of the abdomen. The radiologist (a doctor), guided by ultrasound, a special X-ray machine (fluoroscopy), and dye, inserts a catheter into the main vein in the liver. Once the catheter is in place, a solution containing the islet tissue is infused.
The catheter is taken out and the participant is taken back to a room. The participant lies on his or her right side for four hours.
In some cases, usually when a participant is taking aspirin, the transplant is done during a simple surgery in the operating room, rather than in radiology.
