What is Islet auto-transplantation?
The pancreas contains islet cells, which produce insulin, responsible for regulating blood sugar levels. For certain types of pancreatitis, treatment requires removing the entire pancreas, which is called a total pancreatectomy. If this is done, the body loses its ability to regulate blood sugar levels, and it becomes necessary to manage a very challenging form of diabetes. Therefore, instead of just a pancreatectomy, we perform what is called a total pancreatectomy and islet auto-transplantation (TPIAT). During this procedure, we remove the pancreas, and then we extract the insulin-containing cells and infuse them back into the patient’s liver, where they implant and grow.
Why it's done
The goal of TPIAT is to eradicate pain and reduce or eliminate recurrent hospitalizations. Candidates for TPIAT may include:
- Patients with recurrent acute pancreatitis (RAP)
- Patients with hereditary pancreatitis
- Some patients with pancreas divisum
- Some patients with a variant of chronic pancreatitis unassociated with dilated pancreatic ducts or calcified ductal stones
The Comprehensive Pancreas Cancer and Disease Center is at the forefront of techniques that help people rebuild their quality of life, including TPIAT. We are one of very few centers offering this capability, and our program is led by some of the world’s most experienced and successful physicians in this specialty. Our interdisciplinary team of experts includes surgeons, gastroenterologists, endocrinologists, pain specialists and dietitians. We also have coordinators and nurse practitioners to guide you through the process from evaluation to surgery and recovery.
Starting from the evaluation period, we provide education and support for the operation. This includes diabetic teaching, nutritional support, and education regarding calculating dietary carbohydrates in the diet. Pain management is also discussed. We recommend having an endocrine specialist identified close to your home, as well as a pain clinic if you are currently taking narcotics for pain.