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.
Surgeons at UW Health in Madison, Wisconsin, are now offering combination therapy to treat chronic pancreatitis by performing total pancreatectomy followed by autologous islet transplantation (AIT); a cutting-edge therapy to prevent surgical diabetes after total pancreatectomy. This therapy is only available in a handful of centers in the United States, and UW Health is the only institution in Wisconsin providing this service.
Pancreatectomy with autologous islet transplantation can alleviate pain from chronic pancreatitis in more than 80 percent of patients and prevent the development of surgically-induced brittle diabetes.
Surgical treatment offers:
- Pain relief
- Control of pancreatitis-associated complications of adjacent organs
- Preservation of endocrine pancreatic function
- Social and occupational rehabilitation
- Improvement in quality of life
Total pancreatectomy and islet auto-transplantation represents the best option to cure chronic pancreatitis that is refractory to medical management
During the procedure, the entire pancreas is removed, which leaves the patient in a diabetic state. An autologous islet transplantation is then performed. During islet auto-transplantation, the pancreas is processed and islet cells are removed and reinfused to 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.
- 80 to 90 percent of patients experience complete elimination of pain
- 41 percent of patients remain insulin independent
- 27 percent require less than 10 units of insulin per day with completely stable glucose control (glycated hemoglobin <7 percent)
- 32 percent require an average of 25 units of insulin per day with completely stable glucose control (glycated hemoglobin <7 percent)
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 islet auto-transplantation had not previously undergone surgical resection of the pancreas.
All patients with chronic pancreatitis being considered for total pancreatectomy and AIT 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.
To refer a patient to the UW Health autologous islet program, please call (608) 263-9531.