Islet Cell Transplant and Pancreatitis
Investigating New Treatment for Pancreatitis
By Teresa Vonder Haar
More than 300,000 people in the United States are admitted each year to the hospital with acute pancreatitis, an inflammation of the pancreas, according to the National Institutes of Health.
The most common causes of this condition are gallstones and heavy alcohol use, says Luis F. Lara, M.D., a gastroenterologist who specializes in the treatment of the pancreas and physician on the medical staff at Baylor University Medical Center at Dallas.
“We believe most of the time it occurs because of a toxic effect of a substance on the pancreas or because of an obstruction that is causing the accumulation of the digestive enzymes that are formed in the pancreas,” he says.
Other causes of acute pancreatitis include abdominal trauma, medications, infections, tumors and genetic abnormalities of the pancreas.
Tests Can Reveal Condition
Symptoms of acute pancreatitis include sudden and severe upper abdominal pain that is often heightened after eating, back pain, nausea, vomiting and tenderness. The condition can be diagnosed through a blood test, which shows a higher digestive enzyme elevation or through imaging tests such as ultrasound, CT scan or MRI that will show the inflammation.
The condition usually lasts a couple of days and is treated with intravenous fluids, pain medications, and sometimes antibiotics in the majority of patients according to Dr. Lara.
But patients with gallstones have a high likelihood of another attack, he says. Likewise, if a patient continues to consume alcohol, they can have further inflammation and a return to the hospital.
This condition can lead to chronic pancreatitis.
While rare, chronic pancreatitis is scarring and chronic inflammation of the pancreas that does not heal, and can lead to diarrhea, diabetes and abdominal pain.
The chronic condition may also be due to a genetic disorder, and in some cases can increase the risk of pancreatic cancer.
“Chronic pancreatitis requires close monitoring, and taking away offending factors like alcohol,” Dr. Lara says. “Smoking also can accelerate the condition, so we recommend eliminating it too.” Some patients may benefit from endoscopic or surgical interventions to alleviate the pain.
Research Using the Pancreas Islets
The Liver and Pancreas Center at Baylor Dallas started the program several years ago to treat chronic pancreatitis using the person’s own pancreas islets , which are extracted after removing the pancreas, and then infused the islets back into the patient’s liver. This helps control the pain, but also sustains insulin production, avoiding diabetes.
The medical center was the first in Texas to gain FDA approval to process pancreatic islets for transplantation and is the only hospital in the Southwest performing islet transplantation from its own lab.
Islet auto-transplantation is a “highly selected procedure,” according to Dr. Lara. It is reserved for patients who have intractable pain due to chronic pancreatitis. “The goal is to try to prevent diabetes after the removal of the pancreas.” Other indications for islet auto-transplant are also being studied.POINTS OF CONTACT