A 36-year-old Chicago man is recovering from a partial pancreatectomy followed by an auto-islet cell transplant at the University of Illinois Medical Center at Chicago. The innovative dual procedure was performed in an effort to alleviate the patient's severe, painful pancreatitis while preserving his ability to secrete insulin and avoid surgically induced diabetes.
Surgeons first removed most of the diseased pancreas, leaving behind a small portion of the organ, which may continue to produce enough insulin to support the patient's need to metabolize sugar. However, approximately 30 percent of patients who undergo this surgery develop diabetes. To greatly reduce this risk, a second procedure called auto-islet cell transplantation was carried out using the patient's own pancreatic islet cells.
This combined procedure has been performed in fewer than 50 patients in the United States. A second procedure of this kind is scheduled this week at the University of Illinois Medical Center.
"After a partial pancreatectomy, you never know if the patient will develop diabetes until you find out the hard way," said Dr. Enrico Benedetti, associate professor of surgery at the University of Illinois at Chicago and chief of transplantation at the medical center. "By retaining a small portion of his pancreas, and offering the patient an auto-islet transplant, his chances of developing diabetes are minimal."
After removing approximately 80 percent of the patient's pancreas, physicians prepared the gland by breaking it down with an enzyme that isolates the insulin-producing islet cells. The islet cells were then injected through a catheter into a vein in the patient's liver, where they will graft and function similarly to the removed pancreas. Following a successful transplant, the cells will produce enough insulin to prevent the patient from developing diabetes.
Earlier this year, the medical center opened one of the world's most advanced laboratories for isolating and transplanting the insulin-producing cells of the pancreas in an effort to cure type 1 diabetes, the most severe form of the disease.
"We were able to procure a very large number of high quality islet cells for a successful graft," said Dr. Cristiana Rastellini, director of cell transplant and assistant professor of surgery and immunology at UIC. "I expect that these islets will function very well."
Rastellini is one of the country's leading experts in pancreatic islet cell transplantation.
According to the Society for Surgery of the Alimentary Tract, chronic pancreatitis has an incidence of 5-10 per 100,000 in the United States.
"The patient is doing well," said Dr. Scott Helton, chief of general surgery at UIC who performed the pancreatic resection. "Following his discharge from the hospital, he will be seen in our outpatient clinic, and at that time we will evaluate whether he has insulin independence."
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