Autologous Islet Transplantation for Chronic Pancreatitis
Chronic pancreatitis is a debilitating disease that affects men and women of all ages. It can be hereditary or brought on by certain autoimmune conditions — or the cause can be unknown. It is an inflammation of the pancreas characterized by severe, chronic pain as well as weight loss and malnutrition. While removing a patient’s chronically inflamed pancreas can alleviate pain and other symptoms of pancreatitis, the operation is often avoided because it leaves the patient in a diabetic state. Autologous islet transplantation after pancreatectomy is a cutting-edge therapy that reduces or prevents surgical diabetes after total pancreatectomy.
What is chronic pancreatitis?
Pancreatitis is inflammation of the pancreas, the organ near the stomach and intestines that produces insulin and digestive enzymes. The primary symptom of pancreatitis is pain in the upper stomach, which may also spread to the back. A blood test can help determine if a patient has pancreatitis. And if the condition is advanced patients may present with weight loss, steatorrhea, and/or diabetes.
Pancreatitis may be a one-time occurrence, or it may reoccur as a chronic condition. First-line treatments might include diet and lifestyle changes, pain medicine, and pancreatic enzyme supplementation. If less invasive approaches don’t work, patients may need to undergo surgery to drain excess fluid from the pancreas or remove damaged parts of the organ. Total pancreatectomy is considered only after other treatment options fail. Total pancreatectomy and autologous islet transplantation represents the best option to cure chronic pancreatitis that is refractory to medical management.
Autologous islet transplantation for chronic pancreatitis includes removal of the entire pancreas followed by reinfusion of the patient’s own islet cells — derived from the patient’s extracted pancreas — into the liver. Since the islet cells are the patient’s own there is no need for immunosuppressive therapy. After transplantation, the islet cells produce insulin, thereby reducing or eliminating the need for patients to depend on insulin therapy. This varies by individual, and some patients may require insulin; though this type of diabetes is much more easily managed.
This surgical treatment offers:
Our experience at the University of Wisconsin with autologous islet transplantation has shown:
The likelihood of preventing post-surgical induced diabetes depends on timely referral of patients to prevent further auto-digestion of the gland. In addition, most patients who remain insulin independent following total pancreatectomy and autologous islet transplantation had not previously undergone surgical resection of the pancreas.
All patients with chronic pancreatitis being considered for this combination therapy benefit from discussion in a multidisciplinary forum consisting of surgeons, gastroenterologists, pain specialists, clinical psychologists and endocrinologists. Patients must meet strict criteria before being considered.
For more information
UW Health is the only institution in Wisconsin that offers autologous islet transplantation for chronic pancreatitis. To refer a patient to the UW Health autologous islet program, please call (608) 263-9531. Visit Transplant Services online to learn more about UW Health’s transplantation program.