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A Method for Murine Islet Isolation and Subcapsular Kidney Transplantation
Published on: April 13, 2011
Pediatric Autologous Islet Transplantation
Melena D Bellin1, Sarah J Schwarzenberg, Marie Cook
1Department of Surgery, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN, USA, bell0130@umn.edu.
Insights
Total pancreatectomy and islet autotransplant (TPIAT) provides significant pain relief and enhances quality of life for children with severe pancreatitis. This procedure offers a chance for insulin independence and improved diabetes management.
Area of Science:
- Pediatric Surgery
- Transplantation Immunology
- Endocrinology
Background:
- Chronic pancreatitis in children often leads to severe pain and disability.
- Medical and endoscopic therapies may fail for these patients.
- Total pancreatectomy and islet autotransplant (TPIAT) is a potential surgical option.
Purpose of the Study:
- To evaluate the efficacy of TPIAT in improving pain and quality of life in children with chronic pancreatitis.
- To assess the long-term outcomes of TPIAT, including insulin independence and diabetes control.
Main Methods:
- Surgical resection of the entire pancreas.
- Isolation and autotransplantation of pancreatic islets into the patient's liver.
- Monitoring of islet engraftment, insulin independence, and pain levels.
Main Results:
- The majority of patients experience significant pain relief.
- Over 40% of patients achieve and maintain insulin independence.
- Even patients remaining on insulin show improved diabetes control due to residual islet function.
Conclusions:
- TPIAT is a viable option for children with severe, refractory chronic pancreatitis.
- The procedure offers substantial improvements in quality of life and pain management.
- TPIAT can lead to easier diabetes control and potential insulin independence.
Abstract:
A total pancreatectomy and islet autotransplant (TPIAT) offers substantial pain relief and improved quality of life for children who are severely affected by chronic or recurrent acute pancreatitis and for whom the usual medical and endoscopic therapies have failed. The pancreas is entirely resected, and the pancreatic islets are isolated from the pancreas and infused back into the patient's liver. Because this is an autologous transplant, no immunosuppression is required. Over several months, the islets engraft in the liver; the patient is then slowly weaned off insulin therapy. Slightly more than 40 % of patients become and remain insulin independent, yet even among patients who remain on insulin, most have some islet function, permitting easier diabetes control. The majority of patients experience pain relief, with significant improvements in health-related quality of life. A TPIAT should be considered for children who are significantly disabled by chronic pancreatitis.
