Five things you should know about Total Pancreatectomy and Islet Auto-Transplant (TP-IAT) surgery
Chronic pancreatitis (inflammation of the pancreas) can cause severe, life-altering abdominal pain. Often the only option for pain relief is complete surgical removal of the pancreas and rebuilding of the gastrointestinal tract, called a total pancreatectomy.
Ordinarily, taking out a person’s pancreas would immediately cause diabetes. That’s because islet cells found in the pancreas create insulin, a hormone that helps the body process glucose and balance blood sugar levels. Without a pancreas and its important islet cells, the body can no longer use glucose for energy.
To avoid that outcome our surgeons perform a two-stage procedure known as a total pancreatectomy and islet auto-transplant (TP-IAT). During the procedure, our team conducts surgery to carefully remove the pancreas. They then separates the islet cells from the digestive part of the pancreas in a highly specialized lab. Those cells are then returned to the body using an injection in the patient’s liver. There, they will take root and continue to produce insulin, decreasing or eliminating the chances for diabetes.
It’s a complex procedure, but we’ve broken down the highlights below. Here are five things you should know about TP-IATs.
The two-stage procedure can dramatically improve your quality of life.
Over 90 percent of our patients say their pain is gone or reduced after the surgery. For children with severe hereditary forms of pancreatitis, TP-IAT is often their only option for pain relief.
“Children with pancreatitis are in and out of the hospital, missing school and time with friends,” said M Health Fairview Gastroenterologist Martin Freeman, MD. “After surgery, they can pretty much return to a normal life. It’s the only hope for these kids.”
While all patients begin receiving supplemental insulin shots after surgery to manage their risk for diabetes, some patients are able to eventually stop taking insulin completely. For up to 80 percent of children under 9 years old, the insulin shots are only temporary. Most adult patients need to remain on supplemental insulin, although on average a third eventually no longer need shots. Even those patients who must continue insulin have easier-to-manage diabetes because of the islet transplant.
For patients of all ages, TP-IAT significantly reduces the need for opioid pain medication. Many people with untreated chronic pancreatitis eventually need this type of medication to cope with the pain.
The M Health Fairview adult and pediatric TP-IAT programs are among the most advanced and established programs of their kind in the world.
In 1977 – just over a decade after our surgeons performed the world’s first pancreas transplant – pioneering surgeon David Sutherland, MD, PhD, and his team performed the world’s first TP-IAT procedure as a way to prevent or minimize diabetes after removal of the pancreas. To date, our surgeons have done 800 TP-IAT procedures—the most of any program worldwide.
We have also performed the most pediatric TP-IAT procedures worldwide. To date, we have performed 170 transplants on children between the ages of 3 and 18.
We are one of only a small handful of medical centers in the world that perform this procedure.
“There aren’t a lot of programs that offer TP-IAT, especially to children this young,” said M Health Fairview Pediatric Endocrinologist Melena Bellin, MD. “We’re one of only a few centers with a dedicated clinical team and facility experienced in doing pediatric surgeries.”
Both our adult and pediatric programs are National Pancreas Foundation Centers of Excellence for pancreatitis treatment -- two of only a handful across the country.
