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.
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, pain medication has been substantially reduced for 70 to 80 percent of UCSF patients, and 40 to 50 percent have been able to stop taking pain medication completely.
Innovation and Research
- Member, Collaborative Islet Transplant Registry (CITR)
- Member, Clinical Islet Transplantation (CIT) Consortium
Doctor referral required
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