Type of Surgery
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Last updated: 02/17/2009
The transplantation procedure is very straightforward, relatively noninvasive, and takes less than an hour to complete. After the patient is given light sedation, the surgeon begins by using an ultrasound to guide the placement of a small plastic tube,...
known as a catheter, through the upper abdomen into the liver. The liver is used as the site for transplantation because the portal vein of liver is larger and easier to access than the veins that supply the pancreas, also, it is known that islet cells that grow in the liver closely mimic normal insulin secretion.
Once the catheter is in place, the surgeon takes the cells that have been extracted from the donor pancreas and infuses them into the liver. Extraction is done as close as possible to the time of transplantation because of the fragility of the islet cells. The extraction process uses specialized enzymes to isolate the islet cells from the other cell types found in the pancreas. Only 1–2% of the pancreas is made up of islet cells, an average of two pancreases are needed for one successful transplant.
Recent study has shown that the use of perfluorocarbon in the solution that preserves the pancreas before transplant allows older organs to be used as islet cell donors. New techniques have also been developed that allow the organs to be transported before being used for transplantation. These developments are initial steps to relieving the extreme shortage of donor pancreases needed for the procedure.
During the infusion process, the cells travel through the portal vein and become lodged in the capillaries of the liver, where they remain to produce insulin as they normally would in the pancreas.
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Islet transplantation is the transplantation of isolated islets from a donor pancreas and into another person. It is an experimental treatment for type 1 diabetes mellitus. Once transplanted, the islets begin to produce insulin, actively regulating the level of glucose in the blood.
Islets are usually infused into the patient's liver,. The patient's body, however, will treat the infused islets just as it would any other introduction of foreign tissue: the immune system will attack the islets as it would a viral infection, leading to the risk of transplant rejection. Thus, the patient needs to undergo treatment involving immunosuppressants, which reduce immune system activity. Recent studies have shown that islet transplantation has progressed to the point that 58% of the patients in one study were insulin independent one year after the operation.
In the period from 1999 to 2004, 471 patients with type 1 diabetes have received islet transplants at 43 institutions worldwide.
From http://en.wikipedia.org/wiki/Islet_cell_transplantation
Other Information
Biliary colic is the presenting symptom in 80% of patients with gallstone disease who seek medical care; however, only 10-20% of all individuals with gallstones experience severe gallstone pain.
From: eMedicine
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