The California Cure Harvesting Hope: Dr. Fouad Kandeel

For approximately five years, Robert Weinberg, 47, slept in a recliner at his wife, Susan’s, bedside. He set their alarm clock for 2 a.m., then 4 a.m. to rise and test her blood sugar and administer either orange juice or insulin, depending on whether the reading was low or high. If he had not done so, he risked losing his beloved spouse, whose 26-year ordeal with type 1 diabetes had rendered her unable to work, drive or even be left alone for more than short periods of time.

In late 2003, a friend told Susan about the work of Dr. Fouad Kandeel, director of the Diabetes, Endocrinology and Metabolism division of City of Hope in Duarte. Kandeel is the lead investigator in a multicenter clinical trial of islet transplantation in patients who are incapacitated by their type 1 diabetes.

The first such undertaking in the United States, the goal of this clinical trial is to replicate the results of a similar trial in Edmonton, Canada, in 2000. Susan met the criteria for the trial and underwent her first transplant in June 2004.

“Islet transplantation has been the dream of physicians for over 100 years,” says Kandeel. The procedure requires the harvesting of insulin-producing cells from the pancreases of deceased organ donors. The cells are then transplanted into the liver of the patient via a needle. Even though islet cells are housed in the pancreas of healthy human bodies—an organ typically ravaged in diabetics—the islets are able to produce and secrete insulin in the liver.

In 80 percent of cases, the patient becomes insulin sufficient within one year. Patients are typically functional within 24 hours of the procedure, which takes 30–45 minutes. Full pancreas transplant, the traditional option of severe diabetics, is a two-stage, 10-hour surgery requiring months of recovery time.

But for patients like Weinberg, the choice is clear. Since her 2004 procedure, she has not had one low-blood-sugar episode. She drives herself to her job as a school principal and can even go away for the weekend and have a glass of wine from time to time. “I feel like I’m free, because I felt for so many years like a prisoner,” she says.
—Gwen Moran