Surgeons complete first case of pancreatic “autotransplantation” after traumatic injury
The Washington Post (12/16, Brown) reported that Walter Reed surgeons, alongside a team at the University of Miami Miller School of Medicine, have successfully completed, by their accounts, "the first case of pancreatic 'autotransplantation' after a traumatic injury." The procedure, which "has been done only about 200 times," is "almost always" reserved for patients with pancreatitis. In those instances, patients "travel to the place where the pancreatic cells are extracted and preserved." But, a 21-year-old airman proved to be a rare exception. After being shot "in the back three times by an insurgent," Tre F. Porfirio "underwent two operations in Afghanistan, including one that removed much of his pancreas, before being flown to Germany."
If Porfirio "could survive long enough to get to a specialized transplant center, he could perhaps get a transplant of islet cells from a deceased donor and take anti-rejection drugs for the rest of his life," according to the Los Angeles Times (12/15, Healy) "Booster Shots" blog. "Or doctors could remove his pancreas, leaving him completely dependent on insulin. Either way, an early death from complications of type 1 diabetes was highly likely." Enter the University of Miami. "On Tuesday, Dr. Camillo Ricordi…told the story of a long-distance islet cell transplant." Once Porfirio reached the US, nearly four days after being shot, Walter Reed surgeons removed what was left of his pancreas. Then, the airman's "shattered pancreas" was flown from Walter Reed to "Ricordi's specialized laboratory, more than 1,000 miles away," on the day before Thanksgiving.
The Florida team "received it at 11 pm and spent the next six hours removing the insulin-producing islet cells," the Miami Herald (12/15, Tasker) reported. "Using enzymes and gentle heat, they extracted thousands of the cells, which range from .002 inches to .02 inches across, put them in a plastic bag similar to those used in blood donations, put them back in the container, this time at 46 degrees — and, by 6:30 Thanksgiving morning — couriered it back to Walter Reed." In Washington, DC, "doctors hoisted the bag on a pole and, by gravity, fed the islet cells into a duct in the airman's liver, with Dr. Ricordi and his team coordinating the procedure via an Internet connection." The Monday after Thanksgiving, "the new cells in his liver were producing insulin, although doctors also were giving him extra insulin to avoid stressing the new cells." The Florida Times-Union (12/16, Jackson) also covers the story.
