Total Pancreatectomy with Auto Islet Transplantation
An auto islet transplant, in conjunction with a total pancreatectomy (removal of the pancreas), offers you the opportunity to live a pain free life while maintaining healthy blood glucose control.
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During an auto islet transplantation, your own islet cells are extracted from your pancreas. They are then transplanted into your liver where they begin to grow, producing insulin in a matter of weeks.
How it works
Islet cells are a cluster of cells in the pancreas that produce insulin to help regulate your blood sugar levels. During an auto islet transplatation, the pancreas is carefully mobilized and removed in the operating room; the islet cells are immediately taken to a specialized facility called a clean room, where they are extracted from the pancreas. The islets are then transported back to the operating room in an IV bag where they are transplanted back into the patient by infusion through the portal vein of the liver.
A total pancreatectomy with auto islet transplant provides many chronic pancreatitis patients with a better quality of life, preserving metabolic function, and relieving pain in up to 80% of patients. Approximately 30-40% of patients will not require insulin after the first year of surgery. The rest will need to take a small amount of insulin daily and monitor their glucose levels.
This is a considerably milder treatment than what is seen when a pancreatectomy is performed without an auto islet transplant. Prior to the introduction of the auto islet transplant, patients were forced to choose between the unremitting pain of chronic pancreatitis and a pancreas resection with a lifetime burden of brittle diabetes. The impacts of surgically-induced brittle diabetes - from insulin treatments to blood sugar monitoring systems - can be significant.
The Pancreas Disease Center at Northwell Health does not just offer the same treatments as other centers. We’re at the forefront of techniques that help people rebuild their quality of life. And as one of the only centers in the country performing auto islet transplants, we offer our patients the most groundbreaking treatments.
The Pancreas Disease Center team is led by Dr. Horacio Rilo, who is among the most experienced physicians specializing in auto islet transplants. Prior to joining the Northwell team, Dr. Rilo performed more than 200 clinical islet isolations for transplant into patients suffering from chronic pancreatitis and more than 50 procedures for patients suffering from type 1 diabetes.
Our interdisciplinary team of experts includes surgeons, gastroenterologists, endocrinologists, pain specialists, dietitians, and specialists - including transplant coordinators and nurse practitioners to guide you through the process of diagnosis, development of a treatment plan, preparation for transplant if it is the right procedure for you, going through surgery, and recovery.
We will create an individualized care plan unique to your individual needs and tailored to your medical and surgical history. Developed collaboratively with input from the entire team, your plan will be part of our transplant education that begins during the evaluation period.
We strongly believe that transplant education is critical to your success. The goal of our transplant education is to:
- Increase your knowledge and skills of auto islet transplant management and taking care of your islet cells
- Increase your skills for lifelong management of your islet cells
- Reduce stress and anxiety often experienced by transplant patients
- Reduce chances of complications or problems with your islet cells
- Enhance your decision making capacity and self-esteem in the management of your care
- Improve your results and quality of life
Our education component includes:
- Development of a plan to ensure you have the medical and social support networks in place to ensure transplant success
- Education on proactively following an appropriate diet and exercise program
- Understanding the surgery, recovery time, follow-up period, and long-term transplant management
- Expectations for long term post-transplant management, including caring for your islet cells
- Knowing your insurance benefits and any out-of-pocket expenses you might incur for surgery and over the long-term to manage your health
- Consideration of work, family and other related responsibilities
- Medication information and management
- Resources for islet patients
- Information about Northwell Health and Long Island (hotels, pharmacy, travel, weather, etc.)
- Education for your caregivers
We take incredible care in determining the best course of treatment for each and every person who walks through our doors. Learn more about our patient support and how we help you you throughout your journey.
Potential candidates for the auto islet transplant are people whose pain from pancreatitis has become unmanageable through conventional treatments and medications.
An auto islet transplant may be right for you if you need treatment for pain and illness associated with the following:
- Certain types of pancreatitis
- Pancreatic divisum
- Other disorders of the pancreas
The Pancreas Disease Center can help you determine the right treatment course for you. Contact us at the center and learn more about the comprehensive care provided by our doctors and specialists dedicated to the treatment of pancreatic diseases.
The average AIT surgery lasts around 6 to 8 hours, requiring an inpatient hospital stay of around 2 weeks. Our team can help make this period of time easier for you and your family with our wealth of resources on Long Island, available to you to keep you and your loved ones comfortable while you undergo the procedure.
You will be started on an insulin drip immediately following surgery, which protects the transplanted islet cells from having to work too hard. It also prevents high blood sugar levels during the immediate post-transplant recovery period. The drip is removed when you leave the ICU and are transferred to a post-surgery unit. You may need insulin injections during your hospital stay as the team identifies your post-transplant insulin needs.
It takes about 2-3 weeks for the islets to start producing insulin inside the liver. During this time, we will continue with transplant education, with a particular focus on the daily monitoring and management of your blood sugars.
We ask that you stay in the Long Island/New York area for one month after transplantation so that we can carefully monitor your improvement and continue our transplant education. Once you return home, we will follow up with you at regular intervals to make sure you're on track for for a successful transplant.
If you are not a Long Island resident and your care team are not Northwell physicians, we will make sure to establish a relationship with your caregivers to ensure a seamless transition back to their care. We will work collaboratively with your physicians as a team to ensure long-term transplant success for you.
We will follow up with you often during the first year post-transplant to check on your transplant progress and to identify any issues that need to be addressed. After the first year post-surgery, we will follow up with you several times a year. We’re always available if you have questions or problems that we can address.
We measure the success of our procedure through:
- an absence or significantly decreased need for pain medication
- insulin independence or the need to take maintenance insulin to manage your blood sugars
Find out more about auto islet transplantation. Contact the Pancreas Disease Center now for more information.