[acb-diabetics] transplanted islet cells

[Patricia LaFrance-Wolf]

This article originally posted 15 December, 2009 and appeared in  

Issue 500

 

First Pancreas Removal and Islet Cell Transplantation Performed

 

A 21-year old airman severely wounded in Afghanistan is recovering at Walter
Reed Army Medical Center, Bethesda, MD, after several surgeries and an
unprecedented

transplant.

 

The procedure performed by medical teams at Walter Reed and the University
of Miami's Miller School of Medicine, is the first known case of successful
isolation

and transplantation of insulin producing cells following severe trauma
requiring complete removal of the pancreas.

 

When surgeons found the airman's pancreas to be damaged beyond repair by
gunshot wounds and leaking pancreatic enzymes, which were dissolving
critical abdominal

structures and blood vessels, they had to remove the remaining portion of
the pancreas to prevent further damage.

 

According to Army Col. (Dr.) Craig Shriver, chief of general surgery at
Walter Reed and professor of surgery at Uniformed Services University in
Bethesda,

Md., this was the best decision to prevent further leakage, which could be
fatal. 

 

In islet transplantation surgery, the insulin producing islets are isolated
from a donor pancreas and then reinfused in a patient's liver where they
later

begin to produce insulin.

 

As complete removal of the pancreas results in the most severe and
life-threatening form of diabetes, the pancreas was packed in ice and
transported by

courier to the University of Miami. The organ arrived at 11 p.m., Nov. 23,
the night before Thanksgiving. 

 

Dr. Camillo Ricordi, professor of surgery at the Miller School of Medicine
developed the method for isolating islet cells from the pancreas and is
considered

a pioneer in the field. He immediately agreed to help, in his words,
"anything to help a wounded warrior."

 

A team led by Ricordi at the Diabetes Research Institute at the University
of Miami spent the next six hours performing islet cell (insulin producing
cells)

isolation and purification. The purified islet cells were flown back to
Walter Reed.  

 

Late in the afternoon Nov. 24, Thanksgiving Day, the cells were successfully
injected into the patient's liver, with the University of Miami team
coordinating

the procedure via an internet connection with surgeons at Walter Reed. 

 

Less than one week after surgery, there was clear evidence of pancreas islet
function in the wounded warrior's liver, as shown by the presence of a
specialized

blood test called c-peptide. 

 

As time passes, the pancreatic islets in the liver will take up new blood
supply, and the patient's requirement of exogenous insulin is expected to
decrease,

facilitating diabetes management and preventing the onset of complications
of the disease, and ultimately improving his quality of life. Although the
patient

remains in intensive care for observation, he is stable and responding well
to the procedure.

 

Walter Reed Army Medical Center Public Affairs Office 

 

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