About DIIT

The University of Minnesota is world-renowned as a pioneer of organ transplantation, from deceased human donors and living-donors alike.  This reputation lies at the heart of successful pancreas transplantation, an advanced treatment for diabetes which was pioneered here in 1966. This surgery spawned successful islet (insulin-producing) cell transplantation, offering a variety of options in beta cell replacement therapy to cure diabetes via immunology and transplantation. Diabetes is an auto immune disease whereby its victims lose the ability to produce or effectively use insulin, a hormone that converts carbohydrates to energy.

Typical diabetes management treatments call for manual monitoring of blood sugar levels, via finger sticks and corresponding injections of insulin and an appropriate diet. The patient attempts to keep levels between 70 and 120 mg/dl, inevitably resulting in fluctuations. Although the discovery of insulin in 1922 has allowed many with diabetes to live longer lives, it is not a cure. The only true cure is receiving living tissue, via whole-organ pancreas transplantation or transplantation of only the insulin-producing islet cells, which performs the intended task of monitoring and responding effectively to blood sugar levels.

In 1994, the University of Minnesota Medical School capitalized upon its historic strengths in pancreas transplantation by establishing the Diabetes Institute for Immunology and Transplantation (DIIT) to pursue a cure for diabetes. David E.R. Sutherland, M.D., Ph.D., Head of the Transplantation Division and Professor of Surgery, was named Director of the DIIT. Bernhard J. Hering, M.D., was recruited from Giessen, Germany to head islet transplantation and to serve as an Associate Professor of Surgery.

Passion
Our Vision, Mission, and Logo
Pioneering Treatments for Diabetes
Basic Research
Diabetes and Transplant Immunobiology
Islet Processing and Product Assessment

Our Passion to Help People with Diabetes

Diabetes can have a major impact on the lives of people who have it and those around them. For someone who has it, it can mean not only monitoring and adjusting the food they eat, the activities that they perform, and the medication they take every day of their life, but also the constant awareness that they may develop chronic or acute complications of diabetes mellitus. For the family and friends of a person who has diabetes, it can mean watching someone you love struggle to manage this difficult-to-control disease and helping them if they are unable to take action to help themselves.

The team at the Diabetes Institute for Immunology and Transplantation is passionate about helping people with diabetes. We work for the day when the word diabetes will hold neither meaning nor power.

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Our Vision, Mission, and Logo

Vision

We want all individuals with type 1 diabetes (adults and children alike) to be able to choose – before complications set in – one injection of insulin-producing cells, thus putting an end to diabetes for their lifetime and avoiding the anti rejection drugs that are required to prevent rejection.

Mission and Goals: Pioneering cellular therapeutics to cure diabetes

• To restore insulin independence and tight blood sugar control in people with diabetes using the safest and most efficient cell transplant approach possible.

• To optimize the induction of selective immunologic "tolerance" to transplanted islets, thereby allowing their survival in the absence of immunosuppressive drugs.  Achieving tolerance, which is a natural host mechanism, would preserve the ability of the recipient's immune system to fight infections and avoid the side effects that accompany long-term immunosuppressive treatments.  Achieving this goal would represent a true cure for diabetes.

• To make the cure widely available by developing methodologies that will allow transplantation of abundant pig islets or other potential islet sources (e.g., stem cell and precursor cell derived islet cells).

Logo

The logo above illustrates a recipient of a successful transplant of insulin-producing tissue dancing and enjoying the beauty of a healthy, productive life - free of the many fears and restraints previously imposed by diabetes and insulin dependence.

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Pioneering Treatments for Diabetes

Since the first pancreas transplant was performed here, the University of Minnesota has been dedicated to finding solutions for people with diabetes.  In 1966, doctors William Kelly and Richard Lillehei performed the world's first pancreas transplant at the University of Minnesota.  This historical event proved that surgery could allow a person with diabetes to live without insulin injections.

In the mid-1960s dialysis and kidney transplantation emerged as treatments for people with kidney failure, but not for people with diabetes.  Diabetic people who had kidney disease were rarely accepted for dialysis because their survival rate was low - but their chances for survival without the procedure were zero.  During that time, doctors Lillehei and Kelly realized that by transplanting both a pancreas and a kidney, they could eliminate diabetes in the patient.  In 1967, the world's first simultaneous kidney/pancreas transplant was performed at the University of Minnesota. 

During the 1970s, there were several notable achievements at the University of Minnesota.  In 1974, the world's first islet allograft transplant was performed on a person with diabetes.  In 1977, doctors here performed the world's first islet autograft transplant on a person with pancreatitis.In 1978, Dr. David E.R. Sutherland performed the first series of consistently successful pancreas transplants at the University of Minnesota.  He had followed doctors Lillehei and Kelly's work while he was in medical school at the University of Minnesota.  In 1979, the world's first partial pancreas transplant from a living related donor was performed at the University of Minnesota.

In the 1980s, big improvements were made in pancreas transplantation.  Some advances include new ways to drain the pancreas and better immunosuppression protocols.  Rising success rates in transplantation are closely related to advances in immunology.  In the 1960s, Imuran was introduced and in the early 1980s, Cyclosporine was introduced.  These two medications increased overall success rates of transplants and mitigated the side effects of immunosuppression.  In the mid-1990s, FK506 (also known of as Tacrolimus or Prograf) and mycophenolate mofetil (also known of as CellCept) came on the market.  The introduction of these medications reduced the rejection of pancreases transplants, whether they were done alone, simultaneously with a kidney, or after a kidney transplant.  These drugs have also enabled steroid doses to be greatly reduced or discontinued.

In 1990, the first liver/pancreas transplant in Minnesota was performed at the University of Minnesota.  In 1994, the University founded the Diabetes Institute for Immunology and Transplantation (DIIT) to develop and implement cures for diabetes through the disciplines of transplantation and immunology.  The DIIT is recognized worldwide as one of the pioneers and leaders in pancreas and islet transplantation.  In 1999, the 1,000th pancreas transplant was performed by University of Minnesota surgeons at the University of Minnesota Medical Center, Fairview (formerly called Fairview-University Medical Center).

In 2000, the first simultaneous laparoscopic living donor kidney and pancreas transplant in the world was performed at the University of Minnesota Medical Center.  And, in 2003, the Transplant Department at the University of Minnesota celebrated their 40th year anniversary.

Today, the University of Minnesota's transplant program is the largest - and one of the most successful - in the world.  To date, more than 21,000 patients have received pancreas or islet transplants worldwide.  Nearly ten percent of these transplants have been performed at the University of Minnesota.  In addition, the success rate of pancreas transplants has risen rapidly over the years.  For example, fewer than 10% of pancreas transplants helped patients achieve normal blood glucose levels in the 1970s.  Today, over 80% of pancreas transplant recipients achieve normal blood glucose levels.  And, for each patient, doctors now have a wide range of medications to choose from so they can create significantly more effective immunosuppression protocols using smaller, less toxic doses.

Innovations over the years have improved both the transplant process and long-term success rates.  Surgeons at the University of Minnesota Medical Center, a division of Fairview, have performed the most living donor transplants in the world.  Over 3,000 people have donated whole or partial organs in our transplant programs.  Whole or partial organs that can be donated from living donors include: pancreas, liver, intestine, islet, lung, and kidney.  If a transplant recipient receives half of a pancreas from a living related donor, the genetic match will be improved, thereby decreasing the tendency for their body to reject the partial organ.  Or, if a person with diabetes needs both a kidney and a pancreas, they can receive a kidney from a living donor and a pancreas from a deceased donor.  Since the wait time for a kidney from a deceased donor can be long, this enables the person to receive the life-saving transplants they need in timely manner.

Additional innovations include:

• Modified placement of the transplanted pancreas within the body allows for early detection and reversal of rejection.

• Improved protocols for handling donor tissue lessen the time constraints between procurement and transplantation, allowing patients more time to get to the hospital.

• Transplanted kidneys on a large scale for people with diabetes whose own kidneys have failed.

• Proactive measures to help patients improve the quality of their life and prevent the future complications of diabetes.  Transplantation of a pancreas alone in patients whose diabetes is difficult to control but whose complications have not yet advanced to the point where their kidneys have failed (vs. waiting for the kidney to fail and then performing a simultaneous kidney-pancreas transplant).

• Creation of one of the best islet transplant programs in the world.  The Diabetes Institute for Immunology and Transplantation remains on the cutting-edge of advancements in islet transplantation.

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