10/05/2026
Thank you, Dr. Ricordi, for sharing you expertise on this issue that means so much to the T1D community. We encourage everyone to make their voice heard by sharing comments at Regulations.gov (search 'islet').
What is happening. On September 24, 2026, the U.S. Department of Health and Human Services asked the public a simple question: should islets, the tiny vascularized insulin-producing clusters inside a donated pancreas, be regulated as organs for transplantation instead of as drugs? Anyone can comment until November 9, 2026.
Why it matters to patients. For people with the most dangerous form of type 1 diabetes, repeated severe low blood sugar can cause seizures, loss of consciousness, and death. An islet transplant can stop these episodes. In a U.S. national trial, nearly 9 in 10 patients were free of severe low blood sugar with good glucose control one year later. Yet because the U.S. regulates donor islets as a drug, almost no American hospital can offer them: only 11 new U.S. patients received an islet transplant between 2016 and 2019.
Other countries have moved ahead. Edmonton, Canada, has performed over 700 islet transplants, while France over 300 and both countries cover them under national health insurance. A Shanghai hospital whose team I trained in 2018 has performed about 310 islet transplant procedures. These are also the places where the next breakthroughs, including stem-cell and gene-edited islets that may one day end the need for anti-rejection drugs, are being tested first. Much of this science was born in America, and we are at risk of losing it.
What I am asking for. Treat unmodified donor islets like other donated organs, under the national transplant system, with strict safety standards and public reporting of results. Stem-cell and genetically modified products would remain under full FDA oversight. To be honest about the limits: islet transplants require lifelong anti-rejection medicines and are for carefully selected patients, not for everyone with type 1 diabetes.
How you can help. Go to regulations.gov, search for docket FDA-2026-N-10738, and click “Comment” before November 9, 2026. A few sentences are enough. Tell HHS in your own words how severe low blood sugar has affected you or your family, and you have not had access to the islet transplant procedure so far. Tell why access to islet transplantation in the United States matters. Tell that you hear from transplant centers that they cannot do islets transplantations since islets are regulated as drugs and remain unavailable as such. They could be available if regulated as organs though. Personal comments in your own words carry more weight than copied form letters.
On the FDA page there was a limit of 5000 characters, but the link below brings you to my full comment:
https://diabetesresearch.org/comment-on-deceased-donor-islet-transplantation/