Physician Update - How Islets Stopped the Pain and Returned One Life to Normal
How Islets Stopped the Pain and Returned One Life to Normal
Date: June 28, 2013
It started when her mother learned of The Johns Hopkins Hospital Pancreatitis Center, which houses a team of chronic pain physicians, gastroenterologists, pancreatic surgeons, radiologists and pathologists. There, Sarver met with center director Vikesh Singh, who recommended that she meet pancreatic surgeon Martin Makary.
At this point, Sarver was in constant pain and unable to eat. Her gallbladder had been removed and she relied on a j-tube for sustenance, and she was gradually growing unable to tolerate even that. Surgery, Makary says, was her best option if she ever wanted to live pain-free.
Makary recommended a pancreatic islet transplant—a procedure during which the pancreas is removed and clusters of cells called islets, which are responsible for maintaining healthy blood sugar levels and digestion, are isolated and injected into the liver, where they begin to create insulin.
With the pancreas gone, so is the pain and discomfort. The drawback is that minus a pancreas, patients are unable to produce necessary digestive enzymes and instead have to take them as supplements with meals. Patients also have an increased risk of diabetes and may eventually have to take insulin.
“The patients we operate on are more than willing to trade acquiring diabetes in hopes of getting rid of chronic pain,” Makary says. “A lot of times there is no other option. They’re completely debilitated.”
Sarver underwent the 10-hour operation in November. Her recovery went smoothly, minus a few weeks spent struggling to reintroduce real food to her diet. Today, she says, her life has completely turned around.
“The year before my surgery was one of the worst of my life,” she explains. “Now, I feel like a normal person. I eat without pain. I can support myself, and I’m able to go out and be social. All these are things I never thought would be possible.”
“At Johns Hopkins, the method that we use for pancreatic islet transplantation is unusual in that it involves only a single surgery,” Makary says. “Often, patients must first undergo a separate pancreatectomy, wait for their organ to be processed by an outside laboratory, and then return for a second operation to transplant the cells. We instead perform all of the lab work in the operating room during the same procedure, saving our patients the frustration, anxiety and pain of having to undergo two separate surgeries for the same outcome. “
“Of the many different kinds of surgery I perform in my practice, the islet transplantation is by far the most dramatic and life-changing,” he says. “People go from being completely disabled and in intense pain to having a normal life restored.”
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