Surgeries trade risks for health

In 1966, University surgeons Richard Lillehei and William Kelly gave hope to patients suffering from diabetes and other pancreatic disorders by performing the world’s first pancreas transplant.
Since then, pancreas transplants have become increasingly successful as Fairview-University Medical Center continues to specialize in the operation.
The University hospital is home to the world’s largest pancreas transplant program and has performed more pancreas transplants than any other center in the world. The program celebrated its 1,016th transplant on Jan. 21, according to officials at the Academic Health Center.
The pancreas transplant program benefits people suffering from diabetes, especially Type 1 diabetics. Type 1 diabetes, a disorder in which the body destroys its own insulin-producing cells found in the pancreas, is the leading cause of blindness in adults and accounts for more than 160,000 deaths each year in the United States.
The millions of people with Type 1 diabetes must continually regulate their blood sugar by taking insulin injections up to five times daily.
However, glucose levels cannot be perfectly controlled this way and often lead to kidney failure, heart attack, stroke and even death.
The difference in Type 2 diabetics is their pancreases do produce some insulin, but not a sufficient amount.
Lillehei and Kelly performed 14 pancreas transplants from 1966 to 1973; however, the transplanted pancreas had a low success rate, forcing many patients to return to daily insulin injections. After added research, Drs. David Sutherland and John Najarian resumed the operation in 1978 with much success.
“Our success rate for a simultaneous kidney-pancreas transplantation is now near 90 percent, while our success rate for a pancreas alone transplant is near 70 percent,” said Sutherland, professor of surgery and director of pancreas transplantations. “If a transplanted organ fails, the patient must return to daily insulin injections.”
The rate of a successful organ acceptance in the patient’s body is being helped by anti-rejection pills to prevent this complication.
The University program is leading the way for other institutions worldwide. In 1998, Sutherland’s team performed about 10 percent of all pancreas transplants worldwide. Twelve percent of the transplants were pancreas-only operations, well above the 5 percent national average.
“The most common pancreas transplant is the simultaneous kidney-pancreas transplant because most of the patients have substantial kidney damage and need both a kidney and pancreas, but we do perform pancreas-only operations,” Sutherland said.
One problem with the dual transplant is the two-year waiting list for a kidney; the wait for a pancreas is only six months, he said.
Each year the goals and expectations of the program rise to a new level. Surgeons in the program have already performed 10 pancreas transplants this year as they look to surpass last year’s total of 114.
“Our goals for the future are to increase pancreas-alone transplants by reducing the side effects of the anti-rejection pills, thus raising the success rate,” Sutherland said. “Pancreas transplants are still considered major surgery, and we would also like to simplify this procedure.”