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TPIAT at SUNY-Downstate Medical Center

Total Pancreatectomy with Islet Autotransplantation (TPIAT) at SUNY Downstate Medical Center

The NY Department of Health approved our TPIAT program at the State University of New York (SUNY-Downstate) late in 2018.

Since then, we have performed 4 islet auto-transplants. The first 2 patients are already completely off insulin. Their chronic pain syndrome is significantly imp`roved and they no longer require opioids or narcotics. One of the patients does no longer require total parenteral nutrition. Both patients report a markedly improved quality of life since the operation.

The third patient was already pre-diabetic before undergoing TPIAT (based on elevated Hgb A1c and decreased c-peptide levels). Despite the presence of a very diseased pancreas, approximately 125,000 islets were successfully isolated. Post-operatively, the patient has remained on some insulin but we predict that less than 10-15 units per day will be required long-term. This is less than half the daily insulin requirement for ?typical? Type 1 (insulin-dependent) diabetic patients.

The fourth patient received 405,000 islet with a cell viability of >90%. His c-peptides shortly after TPIAT have been as high as 0.56 (lower range of normal is 0.8), indicating that he may become insulin-independent over the next few months.

We have an excellent, extremely dedicated team of specialists caring for patients with chronic pancreatitis. Our team includes surgeons, gastroenterologists, endocrinologists, pain management specialists, and anesthesiologists. Members of our team have performed or participated in over 100 TPIAT and TP procedures. Our team has been instrumental in developing new surgical techniques both for the conventional open or the minimally invasive (robotic) techniques. Above all, we have not a lost a single patient on the operating table or during the hospital stay despite performing many challenging procedures. Most importantly, we have some of the highest rates of insulin-independence after TPIAT in the country.