Doctors at the University of Miami have developed an improvised way to perform a long-distance organ transplant involving the islet cells of the pancreas, which produces insulin and other enzymes the body requires.
A 21-year-old Air Force enlistee, Tre Francesco Porfirio, was shot while on duty in Afghanistan and his pancreas was essentially destroyed. With an injury like that, Porfirio’s prognosis was very difficult: If he 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. 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 [Los Angeles Times].
So doctors went with an experimental procedure that involved removing the young man’s pancreas, flying it from Walter Reed Army Medical Center in Washington, D.C. to the University of Miami’s Miller School of Medicine. There, a team of doctors, led by Camillo Ricordi, director of the University of Miami’s Diabetes Research Institute, removed and purified the islet cells, flew them back to Walter Reed, and fed them back into Porfirio’s liver through a tube. Within days the cells in the liver began to produce insulin, basically doing the work of the removed pancreas.
Only 15 cities have medical centers equipped to prepare islet cells for transplant, but the new procedure is a way to expand the centers’ reach. Porfirio is unusual also in that his islet cells came from his own pancreas, which, while in shreds, was not dead yet. Most patients must rely on a deceased donor’s pancreas and must take anti-rejection drugs to ensure their immune system doesn’t attack the foreign cells. The ability to use Porfirio’s own islet cells for the transplant, while “very rare,” according to Ricordi, means he will not face rejection issues that make such transplants a lifelong challenge for recipients [Los Angeles Times]. The transplant was performed around Thanksgiving, and is the first of its kind. This procedure, although undoubtedly expensive, may one day become available to patients that have not only suffered pancreatic trauma, but also to those with chronic pancreatitis.
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