History
This is the story of how that breakthrough, known as the Edmonton Protocol, came to be and how it sparked the growth of the Alberta Diabetes Foundation (ADF) to carry its legacy forward.
1979: Dr. Ray Rajotte Begins the Journey
In 1979, Dr. Ray Rajotte joined the University of Alberta with a bold research focus: finding a way to transplant pancreatic islet cells into diabetics. At the time, this idea was daring—isolating fragile insulin-producing cells and getting them to function in a new body was uncharted territory.
Rajotte’s early experiments involved perfecting techniques to isolate and preserve islet cells, even employing cryopreservation methods (freezing cells for later use).
By 1981, he and colleague Dr. Garth Warnock had successfully isolated pure islets from dog pancreases, proving it was possible to extract these cells intact. To translate these advances into a cure, Rajotte founded the Islet Transplantation Group at UAlberta in 1982, assembling a team of surgeons, immunologists and scientists dedicated to islet research.
Before the international recognition, Dr. Ray Rajotte was a young researcher driven by scientific curiosity
1989: First Islet Transplant – A Glimmer of Hope
After years of refining their techniques in the lab, Rajotte’s team achieved a milestone in 1989: they performed Canada’s first transplant of human islet cells into a person with type 1 diabetes.
The islets, infused into the patient’s liver, successfully engrafted and began producing insulin. One patient remained insulin-independent for over two years – a dramatic proof-of-concept that islet transplantation could work.
However, across patients, the procedure’s success rate was only about 8%, and even those who initially went off insulin eventually had to resume injections as the transplanted islets gradually failed. Moreover, powerful anti-rejection drugs were needed, some of which ironically harmed the islets.
Still, 1989 offered a glimmer of hope: it showed that a life without daily insulin injections was not just a fantasy. It motivated Rajotte and his colleagues to push harder, knowing that if they could solve the remaining obstacles, they might truly change the lives of millions with diabetes.
These early years established the scientific foundation – and the community of problem-solvers – that would make the Edmonton Protocol possible.
Photo: Members of the Clinical Islet Transplant Program team. Clockwise from top left: Greg Korbutt, Eddie Ryan, James Shapiro, Ray Rajotte and Jonathan Lakey. - Photo by Richard Siemens
1990s: The Team Behind the Breakthrough
Throughout the 1990s, the Edmonton islet program grew into a multidisciplinary powerhouse. Dr. Rajotte actively recruited talented researchers to Edmonton, expanding the team’s expertise. Notably, Dr. James Shapiro arrived from the UK in 1998 to train under Dr. Norm Kneteman and Rajotte.
Shapiro – a transplant surgeon by training – brought fresh insights into the clinical side of islet transplantation. Working with Rajotte, Dr. Jonathan Lakey (an islet isolation expert), and others, the team zeroed in on a crucial issue: the anti-rejection drug regimen. They discovered that the steroid-based drugs traditionally used to prevent organ rejection were toxic to islet cells, undermining transplant success.
In response, the group explored a new combination of immunosuppressants that eliminated steroids entirely. They also upped the quantity of islets transplanted, using about 11,000 islets per kilogram of the patient’s body weight to ensure a sufficient mass of cells.
By the end of the decade, these refinements dramatically improved outcomes in their experimental protocols. The pieces were in place for a breakthrough: a robust islet isolation method, a healthier anti-rejection drug cocktail, and a team with the right mix of skills.