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

The UCSF Total Pancreatectomy – Islet Auto-Transplant (TP-IAT) Clinic is the only facility west of the Mississippi to offer islet auto-transplantation as a way to minimize diabetes after a total pancreatectomy (surgical removal of the pancreas). 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. It can also be used to treat patients with relapsing acute pancreatitis.

Chronic pancreatitis can severely limit a patient's quality of life. Managing the pain is often difficult, 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 dependent on insulin injections.

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

The technique involves harvesting functioning islets (the cells that make insulin) 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’s pancreas. In chronic pancreatitis, the patient's own islets are used, eliminating the risk of tissue rejection.

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Our 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 to 80 percent of patients at UCSF have had their pain medications substantially decreased, and 40 to 50 percent have been able to stop pain medications completely.

Innovation and Research

  • Member, Collaborative Islet Transplant Registry (CITR)
  • Member, Clinical Islet Transplantation (CIT) Consortium

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    Treatment of Type I Diabetes by Islet Transplantation Into the Gastric Submucosa Study Protocol

    The goal of this trial is to gain initial clinical experience regarding the safety and efficacy of treating type I diabetes in people who have received a kidney transplant by transplanting islets into a new transplan...

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    Pancreas Transplant Services

    400 Parnassus Ave., Seventh Floor
    San Francisco, CA 94143

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