Frequent Flier Miles For Your Pancreas


As befits its subject, I’m writing this post from a plane — a  company was giving out free coupons for in-flight wireless internet, so I’m spending my flight home to New York engaging in everyone’s in-flight entertainment of choice: reading up on diabetes news. (The in-flight movie is Four Christmases — it’s not like I’m missing much.)

As everyone with diabetes knows, traveling with this disease is a major pain in the ass. But I just read an article from the Los Angeles Times about a journey that could best be described as a pain in the pancreas — and which makes carrying around supplies seem like not so much of a big deal. A few days before Christmas, Air Force Senior Airman Tre Francesco Porfirio — then serving in Afghanistan — got shot in the pancreas by three high-velocity bullets. The organ was severely damaged, and Porfirio was looking at a life without insulin. As the article explains, “if he could survive long enough to get to a specialized transplant center, he could perhaps get a transplant of islet cells from a deceased donor and take anti-rejection drugs for the rest of his life. Or doctors could remove his pancreas, leaving him completely dependent on insulin.”

In other words, he’d basically have diabetes — albeit from a very unusual (and violent!) cause.

But that hasn’t come to be.  Instead, his pancreas took a little trip of its own:

On Tuesday, Dr. Camillo Ricordi, director of the University of Miami’s Diabetes Research Institute, described Porfirio’s long-distance islet-cell transplant. The experimental procedure is considered the best hope for treating patients whose pancreas is not functioning, such as those with Type 1 diabetes.

The transplant involved flying Porfirio’s shattered pancreas from an operating room at Walter Reed Army Medical Hospital in Washington, D.C., to Ricordi’s laboratory, more than 1,000 miles away, at the University of Miami’s Miller School of Medicine. There, the organ’s delicate islet cells were extracted and purified.

Then the stew of islet cells was sent back to Walter Reed, where — under the remote supervision of Ricordi’s team in Coral Gables, Fla. — physicians fed the cells through a tube into the airman’s liver.

Within days of the procedure, Porfirio’s islet cells began to produce insulin, effectively doing the work of the excised pancreas.

Nice work, right? Of course, as would-be diabetics go, Porfirio was lucky: his pancreas was still able to make insulin (bullets don’t qualify as autoimmune attacks), so there was something left to extract. And by injecting him with his own cells, researchers avoided the major problem with islet cell transplants: rejection. (Everyone’s body would have a tendency to reject islet cells from a different person; type 1 is even trickier because the very immune system malfunction that destroyed our own islet cells would go after the replacements as well.  It’s like a double whammy.)

The article ends a bit confusingly, claiming that the remote transplant “could mean that patients whose pancreas is destroyed by diabetes or trauma can be treated, potentially, anywhere in the country.” I get that for trauma, but for Type 1 I don’t see how being able to send your pancreas across the country would be helpful (unless your pancreas can start its own frequent flier account). And as long as I’m mentioning pet peeves about diabetes reporting, I question the reporter’s statement that without the treatment, “an early death from complications of Type 1 diabetes was highly likely.” Really? Seems to me that the immediate risk to his health was that he got shot three times in the gut. If that resulted in a missing pancreas, then he’d basically have diabetes — and as we all know by now, well-controlled diabetes does not guarantee one an early death.

But I digress. Point being, this is  great news for Porfirio — and anyone else who, you know, gets shot in the pancreas. (Note to the wise: don’t let that happen.)

In other news, I’ve got a guest post up today on Six Until Me, Kerri Sparling’s great diabetes site. Many thanks to her for the opportunity.

Off to enjoy my complimentary glass of water. . . .

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13 years ago

Well geez, when necrotizing pancreatitis took out a large chunk of my pancreas (including virtually all beta cell function) a little over a year ago, nobody at Mass General Hospital suggested sending it anywhere! Nor has anyone suggested that islet cell regrowth, restoration, transplantation or anything of the sort is likely to be a viable option anytime soon. I’m guessing that damage to the organ has to pretty catastrophic before yanking it out and buying it a plane ticket is something any sane person would consider. I’m thrilled that things worked out so well for this man, and it does… Read more »

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