Rare surgery to treat pancreatitis creates a “super liver” by transplanting pancreatic cells

Toronto – As the number of people suffering from pancreatitis continues to increase, doctors are looking for a rare way to help patients suffering from this chronic pain – using the patient’s own cells to create a “super liver”.

The pancreas, located behind the stomach, produces enzymes that help digestion, and hormones that help you process sugar. Pancreatitis is a disease that interferes with the function of the pancreas. It may attack suddenly and strongly, or it may be a chronic problem.

Kaitlin Saari, 27, was diagnosed with pancreatitis during the pandemic last summer, which is debilitating.

“My condition is getting worse and worse,” she told CTV News. “After anything enters my mouth, I feel more unbearable pain, just like drinking water.”

Although some people with mild pancreatitis get better on their own, severe cases can be life-threatening.

Saari often feels nausea and vomiting. She has no strength to walk or meet friends.

“I can’t even go to bed for a few days,” she said. “I have no life.”

During the COVID-19 lockdown, her condition worsened until she was hospitalized. She suffered severe pain and was hospitalized for several weeks. She could only leave for a few days before being hospitalized again, relying on a large amount of anesthetic to control the pain.

“I live in the hospital,” Sarri said.

Obviously something needs to be done.

The answer comes from a rare operation called “total pancreatectomy and pancreatic islet autotransplantation.”

Saari was the first of two patients treated at Toronto General Hospital and one of the first patients in Ontario to undergo the operation. The first step was to remove her inflamed pancreas in a laborious 12-hour operation.

But removal of the pancreas creates another problem-without a pancreas, patients will develop diabetes and require insulin throughout their lives.

This is why in this new procedure, surgery to remove the pancreas is only the first step.

Laboratory technicians separate the pancreatic cells and send them back to the operating room, where the surgeon injects them into the patient’s liver.

In the liver, these cells root and grow.

Canadian Transplant Surgery and Regenerative Medicine Research Chair Dr. James Shapiro told CTV News that these “islet autotransplants are a very unique situation for surgery.

“Because we want to take out the pancreas of the sick person, we take the cells that make insulin, which accounts for about 1% to 2% of the pancreas, and then put these cells back into the liver,” he said. .

“And because they are the patient’s own cells, the body will accept them without any anti-rejection drugs, so this is a very unique situation. They are very precious cells.”

Saari is a successful case. In 70% of cases, the new “super liver” also begins to produce some or all of the insulin that her body needs.

“I don’t depend on insulin at all now,” Saari said. “It’s fantastic. My blood sugar stays the same […] Every test is normal. “

Hospital officials said that the second patient’s condition is also very good, but he still needs to inject some insulin every day

The incidence of pancreatitis has been increasing worldwide, and doctors are not sure why. Canada now has more than 116,500 new cases of pancreatitis, and its incidence has increased by 75% since 1990.

In 2016, 474 people died of this disease, which makes the development of treatments even more important.

This “super liver” operation was first offered in Alberta, and Shapiro said patients will fly from all over the country to receive this unique operation. They perform operations on approximately 10-15 people each year, including children.

Shapiro said: “We have a two-year-old child who is still not using insulin and has good blood sugar control.”

The operation is now also being performed in Toronto, and Toronto surgeon Dr. Trevor Reichman called it “exciting.”

He told CTV News: “Apart from basically relying on anesthetics, there is a group of patients who don’t have many options in terms of long-term and durable treatment.” “So this is a real opportunity to take care of a group of very challenging patients, and Truly provide them with long-term and lasting treatment to restore their lives in some way.”

He said that the patient will not have any pain after surgery and can continue to live a normal life, which makes it a life-changing process.

This method also has an impact on the wider medical community, and may open the way for the treatment of diabetes itself or the use of patients’ own cells to repair organs.

“This is an exciting and very exciting field,” Dr. Bradly Wouters, Executive Vice President of University Health Network Science and Research, told CTV News.

“This is the larger field of what we call cell and regenerative medicine. It is the idea of ??being able to repair or regenerate tissue.”

Currently, this surgery is only suitable for patients suffering from chronic pain due to pancreatitis. But Wouters explained that if we can transplant these islet cells into diabetic patients, it is possible for these patients to make their own insulin.

This is a question that researchers in Alberta are studying, exploring how to extract patients’ stem cells, grow them into these islet cells and re-inject them to help the body make insulin.

“Theoretically, if we make enough cells, you might be able to cure type 1 and type 2 diabetes,” he said. “Now simplifying the process and scaling up the process is the challenge we face in the laboratory.”

Although accepting Super Liver may not be the answer for everyone with pancreatitis, it is undeniable that it is a step towards a world where our own cells can help replace the function of failed or diseased organs.

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