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(HealthNewsDigest.com) – TUCSON, Ariz. – Surgeons at The University of Arizona Department of Surgery are the first in the Southwest to perform successful auto-islet cell transplants in patients with severe chronic pancreatitis. The dual procedure, which involves removing the pancreas and then putting the patient’s insulin-producing pancreatic islet cells back into the body, was performed this month at University Medical Center on two women in their mid-40s.
One woman, from Tucson, underwent the procedure Aug. 6; the other patient, who traveled to Tucson from Cincinnati, Ohio, had the surgery performed Aug. 13. The innovative procedure alleviates the pain from pancreatitis, while avoiding surgically induced diabetes.
“Chronic pancreatitis can be extremely painful,” said Horacio Rilo, MD, professor of surgery and director of Cellular Transplantation at the UA. “Although a pancreatectomy (removing the pancreas) usually is effective in relieving the debilitating pain in patients when all other treatments fail, it induces permanent diabetes, requiring patients to take insulin shots or use an insulin pump for the rest of their lives.”
In an auto (meaning “self”) islet transplant after a total pancreatectomy, the patient’s own insulin-producing beta cells contained in clusters called “islets” are isolated immediately from the removed pancreas and then put back into the patient’s liver, where they lodge in small blood vessels and release insulin.
“By removing the pancreas and infusing the islet cells back into the body to reduce the risk of surgically induced diabetes, the patient has potential for a much better quality of life,” said Dr. Rilo.
During both operations, the pancreas was removed by the UA Department of Surgery transplant team, led by Rainer Gruessner, MD, professor and surgery department chairman, and included Tun Jie, MD, assistant professor of surgery. The organ was rushed to a specially designed laboratory “clean room” where Dr. Rilo and his team at the UA Cellular Transplantation Institute harvested the islet cells. Then the cells were brought back to the operating room, where Dr. Gruessner infused the cells into the patient’s liver through the portal vein. There they will graft and mimic the function of the removed pancreas and produce insulin.
“The procedure utilizes patients’ own islet cells, which eliminates any threat of rejection and substantially reduces or averts the risk of the patient developing diabetes,” explained Dr. Gruessner. “Had the islet cells not been infused, the patient would likely suffer from a very severe form of diabetes that is particularly difficult to manage and prone to secondary complications of diabetes, such as heart disease, stroke, blindness and vascular diseases.”
Dr. Rilo, a leading expert on islet cell transplantation, recently opened a state-of-the-art “Class 10,000” clean room at the UA for isolating and transplanting the insulin-producing cells of the pancreas. A Class 10,000 clean room facility maintains a positive-pressure environment to ensure that when entering the laboratory, air flows out of the clean room facility, limiting the possibility of contaminants entering the room.
The pancreas is located in the middle of the abdomen, surrounded by most of the abdominal organs such as the liver, spleen and stomach. The organ produces enzymes (exocrine pancreas) essential for digestion and secretes insulin (endocrine pancreas) that controls blood-sugar levels.
Chronic pancreatitis (CP) is an inflammation of the exocrine pancreas that causes irreversible scarring and eventually the destruction of islets. CP can be caused by many things, including hereditary disorders, autoimmune conditions, cystic fibrosis, trauma to the pancreas or heavy alcohol use.
Transplant surgeon Dr. Jie said, “Auto islet transplant is an effective treatment for chronic pancreatitis, but is offered only at a handful of medical centers worldwide. With so few centers offering this procedure, we will be able to help patients not only from Arizona, but from all over the U.S.”
Dr. Gruessner added, “In the future, we will expand the program to treat children with rare familial chronic pancreatitis and type 1 diabetes.”
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