​​​​​​​​​​How do I get referred to the Islet Transplant Program?

You may apply directly, or have your family doctor or your diabetes specialist make a referral to the Islet Transplant Program.

For your referral, you will need to complete an application that includes:

• your general information
• medical information
• blood glucose level readings you take at home
• lab test results

The islet transplant team will review your application. The team includes:

• surgeons
• diabetes specialists
• nurses
• dietitians
• social workers
• psychologists
• administrative staff

The team will contact you by phone if they need more information.

What happens after my application for an islet transplant has been reviewed?

Once your referral application has been reviewed, a member of the transplant team will contact you to talk about what happens next. You will either move on to the assessment phase of the process, or your referral will be declined. If an islet transplant is not right for you at this time, the transplant team will explain what you may need to do and how you can apply again in the future.

If you are moved on to the assessment phase, you will need to get some tests. Assessment tests include, but are not limited to:

• x-rays
• ultrasounds
• lab tests
• heart function tests
• other tests depending on your needs

The transplant team will try to arrange for these tests to happen close to where you live. If this isn’t possible, you may need to come to Edmonton to have these done.

During the assessment phase, you will also need to:

• make an appointment to see your dentist and your eye doctor
• contact a public health centre near you to make sure your immunizations are up-to-date (all of your immunizations should be up-to-date before your transplant)
• meet with islet transplant team members to ask any questions you may have

The timing of these appointments will depend on your current health situation and needs.

When you have finished all of the tests, the islet transplant team will help you decide if a transplant is a good option for you.

Should I have a support person during my islet transplant process?

Yes. In fact, you must have a support person throughout your islet transplant journey. A support person can be anyone you choose. They should be able to help you during all phases of your journey: assessment, waitlist, transplant, recovery, and follow-up. You could choose someone like your partner, a family member, or a good friend. Choose someone who knows you well and is willing to make the commitment.

Your support person will need to:

• encourage you
• listen to your concerns
• help you with taking your medicines
• go to appointments with you
• be there to help you during your recovery

What can I expect on the transplant waitlist?

If the islet transplant team thinks that a transplant is your best treatment option, and you agree, you will be placed on the transplant waitlist.

While you are on the waitlist:

• Make sure that the Islet Transplant Program can contact you at any time. When an organ becomes available, they will need to reach you right away. A cellphone is the best way for the program to reach you. Carry it with you at all times. Make sure that your voice mail is set up. If you have caller ID, calls from hospital phone numbers may show as an unknown number. Make sure you answer these calls and do not block these numbers on your phone. The Islet Transplant Program needs to be able to reach you 24 hours a day. If you do not answer your phone, you may miss your chance for a transplant. Talk to your transplant team if you don't have a cellphone.
• You will need to keep a bag packed and ready for your trip to the hospital. Pack your health card, picture ID, medicines, and comfort items like a bathrobe, slippers, toothbrush, and comb. Don’t bring any jewelry or valuables to the hospital with you. Depending on how you are getting to the hospital, you may need to bring money to cover transportation costs. Your support person can keep a small amount of money in case you need it while you are at the hospital.
• Arrange for someone to get your mail, pay your bills, and take care of your pets and your children while you are away. The Islet Transplant Program is in Edmonton and you should be prepared to stay in the Edmonton area for 1 month after your transplant.
• Continue routine visits with your family physician and diabetes specialist. You are responsible for making these appointments. Continue to have your lab work done as instructed by your healthcare providers, and test your blood glucose daily. Do at least 4 blood glucose tests each day.
• Contact your transplant coordinator to let them know about any changes in your health, like infections, new medicines, or any admissions to a hospital.
• Tell the transplant team if you are planning a vacation, especially if you are leaving the province.
• It is important to stay healthy, eat well, exercise, and get plenty of rest.

There may be times when you are placed “on hold” while on the waitlist. This means that you will not be called in for a transplant during an “on hold” time. Your coordinator will talk to you if this needs to happen.

Waiting for a transplant is difficult. Your transplant team is here to support you and work together towards the goal of transplant.

What happens when I get the call that islet cells are available for my transplant?

There is a limited amount of time during which islet cells can be transplanted. If the transplant team cannot reach you, or if you are not ready, willing, or able to accept the offer, they may offer the islet cells to the next person on the waitlist.

The transplant team will only offer you a transplant if the available islet cells are suitable for you.

Once you have accepted the transplant offer:

• Keep your cellphone with you and keep your phone line free; the transplant team may need to call you again. Call your support person and have them make any other phone calls for you so that your phone line stays open.
• A transplant coordinator (probably not your own coordinator) will talk to you about how you will get to the hospital. This will depend on how far away you live and the timing of the transplant. It’s important to tell the coordinator if there will be any delays in you getting to the hospital.
• Follow the coordinator’s instructions on when to stop eating and drinking. Continue to monitor your blood glucose. If you have a low blood glucose, you will need to treat your low and let the coordinator know this has happened.

In rare cases, after you arrive at the hospital, the transplant team might decide that doing the transplant is not safe or not in your best interest. This is called a “dry run.” If this happens, your transplant will be cancelled and you will go back home. You will need to find your own transportation to get home. If the transplant is cancelled due to a problem with the islets, you will stay on the waitlist and be offered islets again at another time. If the transplant is cancelled due to a safety issue found with you, this may need to be looked at further to make sure it is safe to put you back on the waitlist.

Where do I go to get my islet transplant?

You will go to the University of Alberta Hospital in Edmonton.

Go to the admitting department when you arrive at the hospital, unless the coordinator gives you other instructions.

How is an islet transplant done?

First, you will get 2 intravenous (IV) medicines. One is an insulin drip and the other is for transplant medicines.

The islet transplant usually happens in the radiology department. In rare cases, it might happen in the operating room. Your transplant team uses an ultrasound machine to guide a needle and then a thin tube between your right lower ribs into a main vein (called the portal vein) just below your liver. Your doctor will then give you the islet cells through this thin tube.

You will get medicine to numb your skin before you get the needle. You will also get medicines to help you relax and manage any pain. The transplant takes about 1 hour.