The University of North Carolina (UNC) is among only a few institutions in the United States that offers patients with inflamed pancreas (pancreatitis) or pancreatic cystosis a surgical treatment option that allows a better outcome.
It is relatively common for patients with cystic fibrosis (CF) to develop small cysts in the pancreas (pancreatic cystosis), as a result of impaired hydration of the organ, high protein content secretions, and inflammation. There is no treatment for this condition, and only management of the symptoms or surgical removal of the cysts are possible therapeutic options.
The Chronic Pancreatitis and Autologous Islet Cell Transplant Program in UNC was established in 2016 by Chirag S. Desai, MD. The treatment consists of removing the pancreas while saving, to some extent, the function of secretory cells.
After the pancreatectomy, the clinical team collects healthy cells from the harvested organ and infuses them into the patient’s liver. Implanted in the liver, these cells are able to survive and continue to produce the necessary enzymes and hormones as they do in the pancreas, namely insulin.
With this cell transplant approach it becomes possible to achieve permanent pain relief, while it also can help prevent the development of brittle diabetes — a severe form of insulin-dependent diabetes that is difficult to manage.
In a news article of the UNC School of Medicine, 20-year-old CF patient Magnolia Long shared her success story upon entering the UCN cell transplant program.
For years she experienced severe abdominal pain, nausea, and loss of appetite that were never diagnosed and just accepted to be part of her daily life. It was only in July 2015 that her physicians were able to identify that the cause of her symptoms were several cysts in her pancreas. It was one of the worst cases of pancreatic cystosis her doctors had seen.
With no effective therapies to manage the symptoms, her clinical status was deteriorating and her quality of life affected. She started losing weight due to severe nausea and vomiting.
In an attempt to ease the pain, she underwent endoscopic aspiration to reduce the size of the cysts. But with time the beneficial effects of this approach became less noted.
In October 2016, during one of these procedures, her gallbladder was perforated and needed to be fixed. That’s when Desai took notice of her clinical course after he was consulted on the case.
Desai worked for several months to ensure that the cell transplant procedure was a possibility for Long. The facilities where the pancreas would be disassembled and the cells prepared were created, and the team prepared.
During this time, Long transferred schools to UNC Greensboro to be closer to Chapel Hill for her medical appointments.
“I knew this was going to be a big surgery and I was hesitant at first, even scared. Eventually I realized it was necessary and ultimately the right thing to do,” said Long.
Long was the second patient ever to undergo the procedure in the state of North Carolina. She stayed in the hospital for nine days following the surgery.
The relief was immediate after the surgery, and within three weeks she was back to school. Currently, she is insulin-independent and is taking her routine medication for CF.
“I’m not in pain anymore and it’s wonderful. The surgery helped me, and Dr. Desai was great through the whole process. I know he genuinely cares about my well-being and did everything he could to get me feeling better,” Long said.
This year three patients have received the surgery through the UNC Chronic Pancreatitis and Autologous Islet Cell Transplant Program.
“There are so few places in the country to get this surgery done,” said Desai. “To have this cell transplant initiative here in Chapel Hill offers a new hope to people suffering from pancreatitis in North Carolina, and it lays the groundwork for cell transplant therapy for a variety of diseases in the future.”
To learn more about this treatment program, contact the UNC Center for Transplant Care at (984) 974-5698.