NewYork-Presbyterian/Columbia is developing a comprehensive, interdisciplinary program for autologous islet cell transplantation after total pancreatectomy for chronic pancreatitis.
Pancreatectomy (removal of the pancreas) may be performed when the pain of chronic pancreatitis becomes unbearable. Because the pancreas produces digestive enzymes and hormones including insulin, this surgery is reserved only for those in whom pain is so severe and unremitting that it has led to dependence on narcotic medications. After pancreatectomy, pain is relieved in 93% of cases, but the absence of insulin production leaves patients fully diabetic.
At the Pancreatitis Program at Columbia, a new therapeutic option now enables some patients to undergo pancreatectomy without becoming diabetic. This alternative, called autologous islet transplantation, involves infusion of the patient's own pancreatic islet cells into his or her liver, where they may act like a backup pancreas, independently producing insulin.
In autologous islet cell transplantation, the patient's pancreas is surgically removed. Islet of Langerhans cells (the cells in the pancreas that produce insulin), are isolated from the pancreas and made into a solution. The solution is then infused into the patient's liver, through the hepatic vein. Once in the liver, the islet cells may begin to produce insulin that functions just as it did when produced in the pancreas.
When autologous islet transplantation is successful, the procedure results in patients maintaining normal blood sugar levels without needing insulin.
The Department of Surgery at Columbia is one of only a few U.S. centers, and the only center in the New York metropolitan area, to offer autologous cell transplantation.