Cell transplants make gains versus diabetes.

Transplanting insulin-making cells from fresh cadavers into diabetes patients can reverse the disease, but the procedure has been too costly for widespread use. Scientists have now developed a less costly version of the procedure.

In a trial of cell transplants in eight patients, five were free of disease 1 year after their transplants, a success rate comparable to that of previous cell-transplant trials. However, in those earlier trials, every patient received an infusion of cells from each of two or occasionally more cadavers. Each infusion costs about $75,000, including the first year of follow-up treatment. In the new trial, the transplant cells for each patient came from only one cadaver--a cost-saving procedure that could make cell transplants more commonplace, says study coauthor Bernhard J. Hering of the University of Minnesota in Minneapolis.

After a transplant, the insulin-making pancreas cells from cadavers take up residence in the liver and start producing insulin. For the three patients with unsuccessful outcomes in the recent trial, the transplanted cells didn't manage to establish themselves, Hering says. The immune systems of these three individuals probably rejected the pancreas cells, he adds.

To find the best protocol for the procedure, Hering and his colleagues used a combination of antirejection drugs that didn't include steroids, which often have unpleasant side effects. Rather, the patients received etanercept, an anti-inflammatory arthritis medication, and two other drugs that fight rejection, the researchers report in the Feb. 16 Journal of the American Medical Association.--N.S.