Surgeons Transplant Islets into Patient’s Arm to Prevent Diabetes
By ERIN FAIRCHILD
The Methodist Hospital
A 55-year-old grandmother is producing insulin on her own after her islet cells were removed from her pancreas and implanted into her forearm a few weeks ago at The Methodist Hospital.
Surgeons removed Wanda Prouty’s entire pancreas due to painful chronic pancreatitis, an inflammation or infection of the pancreas.
Next, they implanted islet cells from Prouty’s pancreas into her arm, so she would continue to have functioning islet cells. Islet cells reside in the pancreas and produce insulin to regulate blood sugars. Without islets, patients develop an immediate and advanced form of type 1 diabetes called “brittle” diabetes, which is uncontrolled type 1 diabetes. People with brittle diabetes frequently experience large swings in blood sugar levels, resulting in either hypoglycemia – low blood sugar, or hyperglycemia – high blood sugar.
“In the past, patients who had their pancreases removed had to learn to manage the resulting brittle diabetes, which comes with a 25 percent death rate over five years,” said Craig Fischer, M.D., a Methodist Hospital surgeon specializing in diseases of the pancreas.
After Fischer removed Prouty’s pancreas last month, the pancreas was brought to The Methodist Hospital’s islet lab, where the islets were extracted. Next, Osama Gaber, M.D., head of the transplant division at Methodist, implanted the patient’s islets into her arm. Islets are typically injected into a patient’s liver if the pancreas is no longer working, however this patient had indications of slight liver damage prior to surgery, so the arm was chosen as a stronger alternative site for the islets.
This is the first time this has been done in North America, and early results are very promising, Gaber said.
The Methodist Hospital opened Houston’s first islet laboratory late last year to help patients who have diabetes and other pancreatic diseases. Less than 25 such labs exist in the nation.
In addition to clinical treatments, research conducted in the lab will help advance knowledge about the function of islet cells and their possibilities for patient care.
EYE ON ISLETS––Osama Gaber, M.D., left,director of The Methodist Hospital’s transplant service, and Craig Fischer, M.D., pancreas surgeon at Methodist, examine pancreatic islet cells in the hospital’s islet laboratory.