Advances in Treating Pancreatitis: Autologous Islet Cell Transplantation
NewYork-Presbyterian/Columbia is the first center in the New York metropolitan area to offer autologous islet cell transplantation. Patients who need a total pancreatectomy for chronic pancreatitis or other benign diseases may be eligible for this procedure to prevent type 1 diabetes.
Every year, about 87,000 people in the U.S. receive surgical treatment for pancreatitis. This condition, inflammation of the pancreas, can be very painful – so painful, in fact that relief may only be found when the entire pancreas is removed (total pancreatectomy). This surgery relieves patients’ pain in 90% of cases, but that relief comes at a price: without a pancreas to produce insulin, such patients are left completely diabetic. This is a difficult-to-treat form of diabetes also known as brittle diabetes.
For several decades, physicians and researchers at NewYork-Presbyterian Hospital have been researching ways to treat type 1 diabetes by transplanting insulin-producing islet cells extracted from donor pancreata, a process known as allogeneic islet cell transplantation. This procedure has been adapted for use in certain patients undergoing pancreatic surgery. In this procedure, called autologous islet cell transplantation, the patient’s islet cells are extracted from the pancreas, specially processed, and reinfused into his or her liver. Because the infused islet cells are taken from the patient’s own pancreas, no immunosuppressant therapy is needed, says Beth Schrope, MD, PhD, FACS, who specializes in the treatment of pancreatitis at the Pancreas Center.
When autologous islet transplantation is successful, the reinfused cells produce insulin, acting like a backup pancreas to regulate blood sugar. According to data available so far, about one third of patients require no insulin therapy after autologous islet transplantation. About one third of patients require some insulin after the procedure, and the procedure is unsuccessful in about one third. “It is important to remember that the goal of pancreatectomy is to relieve pain, however,” says Dr. Schrope. “Returning to normal activities and living without pain is a tremendous improvement in patients’ quality of life. If the islet transplantation can prevent the onset of diabetes, that is an added bonus.”