Patients suffering from chronic pancreatitis are often considered for total or near-total pancreatectomy to ameliorate their chronic pain and dependence on narcotic agents. Total pancreatectomy, however, leads to diabetes mellitus and complications. However, advances in the techniques of isolating and purifying pancreatic islets from pancreata have made auto-islet transplantation feasible. Auto-islet transplantation will prevent the development of post-pancreatectomy diabetes and the secondary complications. Pancreatic islets when injected into the portal vein embolize to the liver and eventually re-vascularize. They possibly also re- innervate and have an altered pattern of hormonal secretion. Because allogeneic pancreatic islet transplants have not been uniformly successful, there are few metabolic studies with only limited data. Therefore, we propose to perform 20 auto-islet transplants over a period of 2 years. Seven patients will be studied approximatly 12 months post-pancreatectomy who have received total pancreatectomy without islet transplantation. Isolated islets will be injected into the liver via the portal vein after completion of the pancreatectomy. We will examine (i) the feasibility of total or near-total pancreatectomy followed by auto- islet transplantation on relief of pain, psychological and psychosocial functioning, and narcotic use and (ii) islet function and glucose metabolism. At the Indiana University Medical Center, we have established the infrastructure and experience necessary for isolating, purifying, and testing of human pancreatic islets. As part of our clinical human pancreatic islet transplant program, we have performed 9 allogeneic and 1 auto-islet transplants. The patient who received near-total pancreatectomy and auto-islet transplantation has been free of pain and is insulin independent (4 months). There has been no mortality associated with the procedure.

Project Start
1999-12-01
Project End
2000-11-30
Budget Start
Budget End
Support Year
28
Fiscal Year
2000
Total Cost
Indirect Cost
Name
Indiana University-Purdue University at Indianapolis
Department
Type
DUNS #
005436803
City
Indianapolis
State
IN
Country
United States
Zip Code
46202
Askie, Lisa M; Darlow, Brian A; Finer, Neil et al. (2018) Association Between Oxygen Saturation Targeting and Death or Disability in Extremely Preterm Infants in the Neonatal Oxygenation Prospective Meta-analysis Collaboration. JAMA 319:2190-2201
Robinson-Cohen, Cassianne; Bartz, Traci M; Lai, Dongbing et al. (2018) Genetic Variants Associated with Circulating Fibroblast Growth Factor 23. J Am Soc Nephrol 29:2583-2592
Srinivasan, Lakshmi; Page, Grier; Kirpalani, Haresh et al. (2017) Genome-wide association study of sepsis in extremely premature infants. Arch Dis Child Fetal Neonatal Ed 102:F439-F445
Gupta, Samir K; Yeh, Eunice; Kitch, Douglas W et al. (2017) Bone mineral density reductions after tenofovir disoproxil fumarate initiation and changes in phosphaturia: a secondary analysis of ACTG A5224s. J Antimicrob Chemother 72:2042-2048
Robarge, Jason D; Desta, Zereunesay; Nguyen, Anne T et al. (2017) Effects of exemestane and letrozole therapy on plasma concentrations of estrogens in a randomized trial of postmenopausal women with breast cancer. Breast Cancer Res Treat 161:453-461
Hertz, Daniel L; Speth, Kelly A; Kidwell, Kelley M et al. (2017) Variable aromatase inhibitor plasma concentrations do not correlate with circulating estrogen concentrations in post-menopausal breast cancer patients. Breast Cancer Res Treat 165:659-668
Patel, Yash R; Kirkman, M Sue; Considine, Robert V et al. (2017) Retinopathy predicts progression of fasting plasma glucose: An Early Diabetes Intervention Program (EDIP) analysis. J Diabetes Complications 31:605-610
Robarge, Jason D; Metzger, Ingrid F; Lu, Jessica et al. (2017) Population Pharmacokinetic Modeling To Estimate the Contributions of Genetic and Nongenetic Factors to Efavirenz Disposition. Antimicrob Agents Chemother 61:
Hertz, D L; Kidwell, K M; Seewald, N J et al. (2017) Polymorphisms in drug-metabolizing enzymes and steady-state exemestane concentration in postmenopausal patients with breast cancer. Pharmacogenomics J 17:521-527
Kadakia, Kunal C; Kidwell, Kelley M; Seewald, Nicholas J et al. (2017) Prospective assessment of patient-reported outcomes and estradiol and drug concentrations in patients experiencing toxicity from adjuvant aromatase inhibitors. Breast Cancer Res Treat 164:411-419

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