Pancreatitis

Islet Cell Transplantation for Chronic Pancreatitis

The Autologous Islet Cell Program
The Surgical Procedure
Hospital Stay
Results
Risk Factors
Quality Assurance
In The News

The Autologous Islet Cell Program

The University of Cincinnati (UC) is one of only two centers in the United States that regularly performs islet cell transplantations. Over 100 patients have been successfully treated at UC. Patients express a dramatic improvement in their quality of life after the transplant, and a great majority of patients that had previously been on narcotics to control abdominal pain are able to be weaned off of all pain medications. In addition, our most recent analysis demonstrates that approximately 40% of patients do not require any insulin after surgery. The remaining require minimal insulin or have easy to control blood sugars.

Autologous islet cell transplantation is performed when a total pancreatectomy is the best option for the treatment of chronic, hereditary, or recurrent acute pancreatitis. A total pancreatectomy involves removal of the entire pancreas and leaves the patient unable to produce pancreatic enzymes for digestion and insulin for controlling blood glucose (sugar) level. The patient will be required to take supplemental enzymes and may require insulin for the remainder of his or her life.

Islet cell transplantation allows a patient to be treated for the pain of pancreatitis without the very serious side-effects of a total pancreatectomy, including “brittle diabetes” when a person's blood glucose (sugar) level often swings quickly from high to low and from low to high.

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The Surgical Procedure

A total pancreatectomy is performed through an open surgery technique through a large incision in the abdomen. As soon as the pancreas is removed, it is taken to a highly specialized laboratory just a few minutes away where specialized enzymes are used to remove islet cells from the organ. Islet cells are what produce insulin (which keeps sugars low) and the hormones glucagon and pancreatic polypeptide (which keep sugars high). These islet cells are then purified, processed, and quickly returned to the operating room where the surgeon inserts the islet cells into the patient’s liver through a large vein. In this new and healthy environment, the islet cells can resume their production of the necessary insulin and hormones to maintain normal sugar levels.

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Hospital Stay

Patients typically remain in University Hospital for 10-14 days following surgery to recover from the operation.

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Results

In the most successful cases, patients are insulin-free with normal glucose tolerance, while some patients with less optimal outcomes require small amounts of insulin to treat hyperglycemia (excessively high blood sugar). In addition, most patients are able to either greatly reduce their need for narcotics or may become completely drug-free.

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Risk Factors

Risk factors include those associated with any long surgical procedure, in addition to possible damage to the spleen or liver.

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Quality Assurance

The islet cell laboratory is housed on the UC Academic Health Center campus at Hoxworth Blood Center, which is just minutes away from the University Hospital operating rooms. Hoxworth Blood Center’s Cellular Therapy Division helps staff the laboratory, and its Quality Assurance group oversees strict FDA (Federal Drug Administration) compliance for autologous islet transplantation.

In The News

Click here for a PDF of a recent article about UC's islet cell transplantation program.

Click here for other Survivor Stories.

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