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Islet Autotransplantation for Chronic Pancreatitis

Patients with chronic pancreatitis have the option of having an auto — meaning "self" — islet transplant after a total pancreatectomy, which is the removal of the entire pancreas. A pancreatectomy is usually performed to relieve pain in patients when all other treatments fail, but it induces permanent diabetes, requiring patients to take insulin shots or use an insulin pump for the rest of their lives.

During an islet autotransplant, the patient's own islet cells are isolated from the removed pancreas. They are then put back into the patient, where they start producing insulin. The islet auto-transplant technique is a modification of an islet transplant procedure 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.

This innovative procedure helps alleviate the pain caused by chronic pancreatitis, while preserving the patient’s ability to secrete insulin and reducing the risk of surgically-induced diabetes.

Pioneering Treatment at UCSF

UCSF is the only institution west of the Mississippi to offer islet auto-transplantation as a way to minimize diabetes after pancreatectomy. Pancreatectomy patients who have an islet autotransplant have a 50 percent chance of becoming insulin dependent for life rather than a 100 percent chance without the islet autotransplant.

The UCSF program is directed by transplant surgeon Dr. Andrew Posselt. The multidisciplinary program team includes nurse practitioners familiar with islet transplantation, pain management specialists, endocrinologists, financial counselors, dieticians and social workers. This provides a support network to manage the many issues that relate to chronic pancreatitis.

Positive Outcomes

At UCSF, a small group of 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% of patients at UCSF have had a substantial decrease in their pain medications, and 40-50% have been able to stop pain medications completely.

Location

Office Address: 505 Parnassus Avenue, Room M896, San Francisco CA 94143-0780

Clinic Address: Connie Frank Transplant Clinic, 400 Parnassus Avenue, 7th Floor, San Francisco, CA 94143

 

Reviewed by health care specialists at UCSF Medical Center.

Related Information

How to Reach Us

Phone: 415 353-1473

Fax: 415 353-8709

islettransplant@ucsfmedctr.org

UCSF Clinics & Centers

Pancreas Transplant
400 Parnassus Ave., Seventh Floor
San Francisco, CA 94143
Phone: (415) 353-1551
Pre-Transplant Fax: (415) 353-8708
Post-Transplant Fax: (415) 353-4183

Condition Information

Our Experts

Andrew Posselt
Dr. Andrew Posselt,
bariatric and transplant surgeon
Umesh Masharani
Dr. Umesh Masharani,
endocrinologist
James Ostroff
Dr. James Ostroff,
gastroenterologist