A Randomized Trial of Intraportal Alone Versus Intraportal and Extraportal Transplantation of Pancreatic Islets After Total Pancreatectomy for Chronic Pancreatitis
Abstract
Objectives/Rationale: Chronic pancreatitis affects as many as 1 in every 2,500 persons and is associated with incapacitating pain, frequent hospitalization, and risk of narcotic dependence. This is a debilitating disease with limited treatment options; afflicted patients are often young or middle-aged adults. The health and economic costs of pancreatitis are great. One treatment for certain types of chronic pancreatitis is total pancreatectomy with islet autotransplantation (TPIAT). In this procedure, the patient’s pancreas is removed (eliminating the source of the pain) and the patient’s islets, which produce insulin and other important hormones, are harvested from the pancreas and transplanted into the liver thru the portal vein. This procedure is limited by the number of islets removed in the disease pancreas and problems with the islets functioning normally in the liver. We propose a pilot study to evaluate outcomes when a portion of the islets are placed in an omental pouch (in fatty tissue of the abdomen) to evaluate safety and islet function using this alternative site. Topic Areas Addressed: This proposal addresses needs in two broad topic areas: pancreatitis and diabetes. We propose to investigate a new technique for implanting autologous pancreatic islet cells into patients undergoing surgery for acute recurrent or chronic pancreatitis in an effort to improve long-term diabetes control. In the area of diabetes, we anticipate that this work will lead to improved long-term function of pancreatic islets, addressing the area of encouragement of “…transplantation of allogenic or autologous pancreatic islet cells for long-term natural insulin production….” In the area of pancreatitis, the proposed work addresses the need for innovative therapeutics for acute recurrent and chronic pancreatitis. Applicability/Impact: Our work has the potential to improve the lives of patients suffering from chronic pancreatitis who do not respond to medical therapy, making the TPIAT a more viable and functional outcome, and potentially decreasing the number of patients who struggle with diabetes mellitus after this life-improving surgery. In addition to improving outcomes in patients with chronic pancreatitis, this technique is potentially applicable to improving function in patients receiving allotransplantation for treatment of diabetes.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810687
Entities
People
- Gregory Beilman
Organizations
- United States Army
- University of Minnesota