Objective
To identify blood-based molecular signals that can predict early graft injury and long-term success after pancreas or islet transplantation in people with type 1 diabetes.
Background Rationale
While pancreas and islet transplantation can restore insulin production, outcomes vary widely between individuals. Currently, doctors rely on glucose levels and C-peptide measurements, which often indicate damage only after insulin-producing cells have already been lost. There is a critical need for earlier, non-invasive markers that can signal graft stress or injury soon after transplantation.
Description of Project
Pancreas and islet transplantation can restore natural insulin production in people with severe type 1 diabetes (T1D), offering freedom from insulin injections and protection from dangerous low blood sugars. However, not all transplants succeed equally well. Some grafts function for many years, while others lose insulin-producing cells early after transplant. Currently, clinicians have no reliable way to predict which transplants are at risk of early failure until damage has already occurred.
This project aims to address this critical gap by studying the biological signals released by transplanted pancreas and islet cells and how these signals appear in the blood of transplant recipients over time. By collecting blood and tissue samples from people undergoing pancreas or islet transplantation and following them closely after transplant, we will identify molecular patterns that indicate whether a graft is healthy, under stress, or at risk of failure.
The study will combine advanced laboratory techniques, including metabolomics and proteomics, with detailed clinical information collected as part of routine transplant care. Importantly, this research does not test a new drug or treatment. Instead, it focuses on improving how we monitor transplants and understand why some transplants succeed while others fail.
The ultimate goal is to develop a blood-based test that can detect early warning signs of graft injury before irreversible loss of insulin-producing cells occurs. Such a tool could allow doctors to intervene earlier, tailor immunosuppression more precisely, and improve long-term outcomes for people living with T1D. In the future, these findings may also help improve emerging cell replacement therapies, including stem-cell-derived islet treatments.
Anticipated Outcome
The study will identify molecular patterns in blood that reflect the health of transplanted pancreatic tissue and islet cells. The anticipated outcome is the development of a serum-based biomarker panel capable of detecting early graft dysfunction, improving risk stratification, and guiding clinical monitoring before irreversible damage occurs.
Relevance to T1D
Improving graft survival directly improves quality of life for people with T1D by prolonging insulin independence and reducing complications. The knowledge gained from this study will also support future cell replacement strategies, including stem-cell derives islets, helping move the field closer to a durable cure for T1D.