Islet Transplant Evaluation

If the transplant team decides you are a potential candidate for islet transplantation, you will be asked to attend an islet transplant orientation. This orientation is a chance to learn more about islet transplantation and the studies being conducted at Emory. A member of the islet transplant team will explain the evaluation process, the transplant process, and the testing and care that take place after the transplant. Patients are invited to bring a friend or family member to the orientation, and questions are encouraged.

During the orientation, the islet transplant "informed consent" document will be carefully explained. This consent is an important part of a clinical trial and provides detailed information about the study, including the risks and benefits. If you wish to continue the evaluation process after the orientation, you'll be asked to sign the informed consent.

Step 1: Consultation

Patients who choose to proceed will be scheduled for consultation with an endocrinologist. The consultation visit will take about eight hours.

At this appointment, you will submit:

• 28-day record of blood glucose levels, insulin dosages, and hypoglycemia episodes
• 24-hour urine specimen

• Blood to test for blood type, comprehensive metabolic panel (blood chemistries), lipid profile (cholesterol), hemoglobin A1C, kidney function test, thyroid test, complete blood count (CBC), blood clotting test, HLA antibody and tissue typing. The endocrinologist will complete a history and physical exam and review your blood glucose records.

Step 2: Day 1 Evaluation

The islet transplant team will review the information obtained during your consultation. If you still meet the criteria, you’ll be asked to participate in another day-long evaluation. You will meet with the Transplant Surgeon during this visit, and have the opportunity to ask questions.

The following tests will be performed:

• Dobutamine stress echocardiogram (heart)
• Electrocardiogram (heart)
• Chest X-ray (lungs)
• Abdominal ultrasound (liver)
• Consultation with a transplant social worker

Blood is drawn for the following tests:

• C-peptide (a test that determines insulin production)
• Toxicology (drug screen)
• Tests for hepatitis B and C, HIV, HTLV, and syphilis
• Pregnancy test (women)
• Tests to determine your prior exposure to certain viruses like CMV, EBV, and chicken pox
• Urine tests for albumin, protein, and creatinine

Step 3: Day 2 Evaluation

The islet transplant team will review the information obtained during your evaluation. If you continue to meet eligibility criteria, you’ll be asked to participate in a third full-day evaluation.

The following tests completed during this visit provide "baseline" data that can be compared to similar tests after transplant:

• IV glucose tolerance test
• Retinal photography
• 3-day continuous glucose monitoring

Step 4: Placement on the Transplant Waiting List

After you have completed the evaluation and all results have been reviewed by the transplant team, if you continue to meet all eligibility criteria and you choose to move forward,  you will be placed on the islet transplant waiting list. You will be scheduled for follow-up testing every 3 months while you are on the transplant waiting list.

What if I'm not eligible for the study?

Applicants who do not meet the criteria for any of the current studies in islet transplant at Emory will be informed as soon as possible after that determination is made. All applications are kept on file and will be considered for future studies at Emory if the criteria for eligibility change. Applicants are encouraged to contact us at any time to inquire about our progress and about current studies. Emory's endocrinologist will also be available to assist applicants and their doctors with issues concerning management of diabetes.