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Total Pancreatectomy - Islet Auto Transplant (TP-IAT) Clinic

At UCSF's Total Pancreatectomy – Islet Auto Transplant (TP-IAT) clinic we are experts in treating diseases of the pancreas and biliary system. UCSF is the only facility west of the Mississippi (and the only one on the West for pediatric patients) to offer islet auto-transplantation as a way to minimize diabetes after a total pancreatectomy or removal of the pancreas. This innovative procedure helps alleviate the pain caused by chronic pancreatitis, while preserving a patient's ability to secrete insulin and reducing their risk of developing surgically-induced diabetes.

Chronic pancreatitis can severely limit a patient's quality of life. It is often difficult to manage the pain associated with the condition and patients are frequently too disabled to work. Severely ill patients have traditionally been treated by removing the pancreas, but this leaves them diabetic and reliant on external sources of insulin.

A total pancreatectomy followed by an islet auto transplantation is a complicated procedure that requires expertise and training provided by only a select few medical centers in the world. The depth and breadth of transplant experience at UCSF has played a vital role in enhancing our ability to perform islet auto-transplantation safely and effectively.

The technique involves harvesting functioning islets from the patient's diseased pancreas and then infusing them into the portal vein, where they migrate to the liver. The islet auto-transplant technique is a modification of one used to manage severe insulin-dependent (type 1) diabetes, in which islets are isolated from a deceased donor pancreas. In chronic pancreatitis, the patient's own islets are used, eliminating the risk of tissue rejection.

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Volume and Outcomes

At UCSF, eight patients have undergone total pancreatectomy with islet auto-transplantation since 2006. All have survived, and more than half did not require insulin after the procedure. In keeping with results from the few other institutions using the technique, 70-80 percent of patients at UCSF have had a substantial decrease in their pain medications, and 40-50% have been able to stop pain medications completely.

Innovation and research

  • Member, Collaborative Islet Transplant Registry (CITR)
  • Member, Consortium on Islet Transplant (CIT)
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You'll need a referral from your primary care provider or specialist to make an appointment. Once you have the referral, please call the number below.

Getting Here

Total Pancreatectomy - Islet Auto Transplant (TP-IAT)
400 Parnassus Avenue, 7th Floor
San Francisco CA 94143-0780
Phone: (415) 353-1473
Fax: (415) 353-8709

What to Bring

  • Health insurance information including authorizations or referrals
  • List of prescription medications and dosages
  • List of medications that you're allergic to
  • List of questions you may have
  • Recent test results related to your condition
  • Paper and pencil to take notes

Research and Clinical Trials

Conditions Treated

  • Chronic pancreatitis
  • Relapsing acute pancreatitis
  • The procedure is a good choice for highly motivated patients with a strong social support structure, including a primary care physician who can monitor their withdrawal from pain medications. Ideal patients have not yet developed diabetes from destruction of the pancreas and islets, nor have they had other pancreatic surgeries, which often produce scarring and consequently lower the islet yield. However, patients are evaluated on an individual basis.
Related Information

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Clinics & Centers

Clinic Team

Andrew Posselt
Dr. Andrew Posselt,
bariatric and transplant surgeon
Umesh Masharani
Dr. Umesh Masharani,
endocrinologist
James Ostroff
Dr. James Ostroff,
gastroenterologist
Marlene Bedrich
Marlene Bedrich,
diabetes educator