In April 2022, the Pancreas Care Center team at Cincinnati Children’s performed its 100th total pancreatectomy with islet autotransplantation (TPIAT). This complex procedure can ease the severe pain caused by recurrent and chronic pancreatitis and allow children to fully participate in school, family activities and sports.

The center, founded in 2012, receives over 100 new referrals for pancreatitis per year. The pancreas team performs 20 to 25 TPIAT procedures a year on patients as young as 3 years old when indicated.

• Over 90% of patients no longer need pain medications three months after surgery.

• A year after surgery:

• 30% of patients no longer need insulin.

• Half of the patients require very low insulin.

• Only 20% of patients need full insulin coverage.

A Comprehensive Team Approach

TPIAT involves removing the entire pancreas and reconstructing the gastrointestinal tract. After the pancreas is removed, it is taken to a laboratory, where skilled technicians remove islet cells, which are responsible for producing insulin and other hormones. The islets are infused into the patient’s liver via the portal vein.

Constant Program Innovation and Improvement

Children who may be candidates for TPIAT receive a comprehensive evaluation that may last up to two days.

“Paired with research and novel discoveries, we have developed standardized criteria to understand which patients will benefit from TPIAT and develop an individualized care pathway for each child,” says Maisam Abu-El-Haija, MD, MS, medical director of the Pancreas Care Center. “Each pathway reflects the patient’s lifestyle and holistic needs.”

A team approach allows Cincinnati Children’s to care for every aspect of a child’s well-being before, during and after surgery. The team includes physicians (endocrinologists, endoscopists, gastroenterologists, and infectious disease and pain management specialists) and pediatric surgeons, as well as social workers, genetic counselors and behavioral health experts.

Research is an important aspect of the center’s work. Team members are involved in and lead several multicenter studies and receive grant funding from the National Institutes of Health (NIH) and the National Pancreas Foundation.

Current research focuses on:

• Acute pancreatitis-related studies for natural history and outcomes

• Identifying biomarkers to quantify chronic pancreatitis

• Pancreas function studies

• Studies of islet cell function protocols

Enabling a Return to Normal Life

Patients, families and providers develop tight bonds as children progress from surgical evaluation to treatment to recovery.

“Children who undergo TPIAT need an incredible amount of support and care from their providers and caregivers,” says Deborah Elder, MD, endocrine director of the Pancreas Care Center.

“Our team follows the post-TPIAT patient closely after hospital discharge, and at each visit the children are feeling better and standing a little straighter. The entire team witnesses their recovery. Before you know it, they are back to school and sports and all the normal childhood activities that make life fun.”