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Wounded Soldier Spared Diabetes With Emergency Transplant
Date:4/21/2010

Improvised surgery saved his life, and may lead to new options to treat type 1 diabetes,,

WEDNESDAY, April 21 (HealthDay News) -- In the first operation of its kind, a wounded soldier whose damaged pancreas had to be removed was able to have his own insulin-producing islet cells transplanted back into him, sparing him from a life with the most severe form of type 1 diabetes.

In November 2009, 21-year-old Senior Airman Tre Porfirio was serving in a remote area of Afghanistan when an insurgent who had been pretending to be a soldier in the Afghan army shot him three times at close range with a high-velocity rifle.

After undergoing two surgeries in the field to stop the bleeding, Porfirio was transferred to the Walter Reed Army Medical Center in Washington, D.C. As part of the surgery in the field, a portion of Porfirio's stomach, the gallbladder, the duodenum, and a section of his pancreas had been removed.

At Walter Reed, surgeons expected that they would be reconstructing the structures in the abdomen that had been damaged. However, they quickly discovered that the remaining portion of the pancreas was leaking pancreatic enzymes that were dissolving parts of other organs and blood vessels, according to their report in the April 22 issue of the New England Journal of Medicine.

"When I went into surgery with Tre, my intention was to reconnect everything, but I discovered a very dire, dangerous situation," said Dr. Craig Shriver, Walter Reed's chief of general surgery.

"I knew I would now have to remove the remainder of his pancreas, but I also knew that leads to a life-threatening form of diabetes. The pancreas makes insulin and glucagon, which take out the extremes of very high and very low blood sugar," Shriver explained.

Because he didn't want to leave this soldier with this life-threatening condition, Shriver consulted with his Walter Reed colleague, transplant surgeon Dr.
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