Issue No. 18
Another ChanceDate: October 24, 2012
Sufferers of a rare pancreatic condition have new hope for a pain-free future
Chronic pancreatitis is a rare and painful condition that compromises the pancreas and prevents the hormone insulin from helping regulate the body’s metabolism. The disease affects only about 40 out of 100,000 people, but traditionally the only option for some sufferers has been the full removal of the pancreas.
Now, there is a revolutionary operation known as islet autotransplantation, which gives hope to sufferers that they can keep at least part of their pancreas. Despite the condition’s rarity, Johns Hopkins performs about one of these procedures every month.
Islet autotransplantation is performed at several centers nationwide, but Johns Hopkins is the only one performing the laboratory isolation of islets, in which the pancreas is fully or partially removed from the patient during the operation. Islets, which are groups of cells in the pancreas that produce insulin, are removed and transplanted back into the liver, where they can grow in the liver’s plentiful blood supply and produce insulin, which the body desperately needs.
In the past, many people with chronic pancreatitis had few treatment options, and suffered through severe abdominal pain, nausea and fever.
“These patients have intractable and disabling pain to the point where they are desperate and are dependent on intravenous nutrition—sometimes for years,” says Marty Makary, M.D., director of the Johns Hopkins Pancreas Islet Transplant Center. “It is one of the most debilitating diseases in medicine. Other centers can require two separate procedures—one to isolate the islets and another to transplant them. We have now pioneered the procedure to develop a single-stage operation.”
People ideally suited for the procedure have what is known as small duct chronic pancreatitis and also have severe disability. Some insurers cover parts or all of the auto islet transplant; Medicare will cover the removal of the pancreas.
People who come to Johns Hopkins are carefully evaluated and then treated by a multidisciplinary team involving more than 15 specialists.
“This operation has dramatic results, and is a life-changing intervention,” Makary says.
Did You Know?
- Johns Hopkins surgeon and researcher John Cameron, M.D., helped pioneer the islet transplant in the late 1970s. Centers like Johns Hopkins have continually refined the technique over the years.
- Auto islet transplant surgery typically takes eight to 10 hours.
- Eligibility is determined after medical testing by a team including a surgeon, a gastroenterologist, an endocrinologist, a nutritionist and possibly a chronic pain psychiatrist.
- About 80 percent of people experience significant reduction, if not resolution, of pain after this procedure.
Go online to learn more about auto islet transplants and to watch an animation of the transplant procedure. Visit bit.ly/auto-islet.