One Talk With... Dr. Toby Coates

28 Sep 2021

Islet transplantation has raised significant interest amongst the T1D community as a potential game changing treatment. 

This treatment enables people living with T1D to produce their own insulin naturally, which can significantly reduce the day to day challenges of managing blood sugar levels. However, it comes with it's own set of risks and limitations, which many T1D researchers are working to overcome. One of these researchers is Dr. Toby Coates, who is trialling an innovative new method of islet transplantation that could allow more people to access this procedure.

Funds raised in the One Walk Step Challenge will support the most promising areas of Australian T1D research. Dr. Toby Coates and his work on islet transplantation, is one of the research areas One Walk will be supporting this year. Here’s a deeper dive. 

“I was inspired by the strength of a patient who had kidney failure from T1D at the age of 19…he has been my patient ever since”

When asked what drove Dr. Coates to pursue his current line of work he recalls, “I was inspired by the strength of a patient who had kidney failure from T1D at the age of 19 – I met the patient when I was a junior doctor, and he has been my patient ever since”.

Dr Coates is interested in the idea of treating people by transplanting individual cells, rather than whole organs. He and his team have performed dozens of  islet cell transplants for people with severe T1D, but a shortage of donor islet cells and the invasive nature of the procedure means it is not appropriate for everyone. Now, Dr Coates wants to overcome some of these challenges to make islet transplantation procedure available to even more people. 

“I want to use transplants to replace the need for insulin – by getting people with T1D to produce their own insulin naturally in the body”

Islet transplantation involves taking healthy islet cells from a donor pancreas, and transferring them into a person with T1D. When asked about the impact Dr. Coates aims to achieve, he states “I want to use transplants to replace the need for insulin – by getting people to produce their own insulin naturally in the body”.

The liver is the most common site of islet transplantation, but this organ is extremely difficult to access, making transplantation difficult and impossible to monitor the transplanted cells. Each transplant also requires a large number of donor islet cells to be successful. 

Dr. Coates is looking to overcome these limitations. 

“Growing islet cells from stem cells to use in a transplant, rather than relying on cells from a donor – means more people can have access to islet transplants”

Dr. Coates aims to address the challenge of accessing the liver with his method of transplanting islet cells via the skin. This method involves injecting donor islet cells within a type of artificial skin which provides the cells with blood supply.

Several JDRF-funded studies led by Dr. Toby Coates proved this method of islet transplantation to be safe on animals. He is now trialling this method in people for the first time by running a clinical trial. This could be a game changer for people with T1D if this is proven a success!

 Dr. Coates is also working on using stem cells to create islet cells to address the shortage of donor cells. He states “Growing islet cells from stem cells to use in a transplant, rather than relying on cells from a donor – means more people can have access to islet transplants”.

“By supporting our research, you are helping us help you”

By raising funds for promising research areas such as Dr. Coates’ islet transplantation clinical trial, you are helping researchers find the next breakthrough treatment which has the potential to change people’s lives. As Dr. Coates puts it, “by supporting our research, you are helping us help you”.