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

Rahul Jindal.

Jindal said that Porfirio could receive a pancreas transplant from a matched donor at a later date, but that would require lifelong use of immune-suppressing medications. Another option, Jindal said, was a transplant using Porfirio's own islet cells -- cells within the pancreas that produce insulin and glucagon. The procedure is known as autologous islet cell transplantion. Such a procedure had never been done in this type of situation, Jindal said.

"I called one of my colleagues in the transplant field, Dr. Camillo Ricordi [chief of cellular transplantation at the University of Miami Diabetes Research Institute], and he was ready to give it a try. We had about half the pancreas left, which we removed and sent to Miami, as we would an organ for donation," said Jindal.

In the meantime, because it was the evening before Thanksgiving and many people had gone home early, Ricordi had to re-assemble a team of technologists to harvest Porfirio's islet cells. Islet cell transplantation was initially developed with the hope of curing type 1 diabetes. And, while it's temporarily helpful for those with the disease, the autoimmune attack that caused diabetes in the first place eventually destroys the transplanted cells as well. Researchers have also used islet cell transplants to help people with chronic pancreatitis.

"I was concerned," said Ricordi. "It was the first time we'd done a remote procedure where there isn't a human cell processing center on the receiving end. But, I thought no matter, what we could give back in islet cells would be a good help. I didn't predict that we'd be able to get him off insulin therapy completely."

Less than 24 hours later, the harvested islet cells were back at Walter Reed, ready to be infused into Porfirio. According to Ricordi, the procedure to infuse the islet cells into the liver is relatively simple. They're infused into the portal vein in the liver, and then they "seed
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