Team plays key role in islet auto-transplant surgery

A team of South Australian surgeons, with the support and collaboration of local, national and international experts, have performed an Australian-first operation at the Women’s and Children’s Hospital (WCH).

Health Minister Jack Snelling said Australia’s first paediatric islet auto-transplant was a “remarkable” surgery, giving a 7 year old boy with hereditary pancreatitis a chance at a much better childhood and adult life.

“I congratulate the wonderfully talented and specialist staff involved in this pioneering surgery, which was undertaken after extensive ethical review and with international consultation – I understand an 18-month Process altogether,” Minister Snelling said.

“That this operation was performed is a testament to South Australia’s health system and to the courage and determination of our medical staff and scientists.”

Pancreatitis is inflammation of the pancreas, an organ of the digestive and endocrine systems. The pancreas makes the hormone insulin, which regulates blood sugar levels.

Dr Richard Couper, Consultant, Gastroenterology at the WCH said the patient was a boy with a gene defect that causes severe pancreatitis, an extremely painful condition that would have led to diabetes.

After much planning and consultation with local, interstate and international experts, as well as the boy’s family, the ground breaking surgery was performed on 14 July 2015.

His pancreas was removed and taken to St Vincent’s Institute of Medical Research in Melbourne where an expert team, including Dr Balamurugan Appakalai** – an international pioneer in islet cell isolation – was able to identify and isolate the pancreatic cells responsible for producing insulin (islets). (See photo)

Professor Toby Coates, Director of Kidney and Islet Transplantation at the Royal Adelaide Hospital, said the islets were then taken back to Adelaide by members of the Adelaide islet transplant team, where they were ‘re-infused’ back into the patient’s liver on the same day.

It is hoped that the boy’s liver, through the islet cells, will now produce the insulin he needs.

“By removing his pancreas and isolating the islets, his pain will be much better, allowing him to come off opiates and hopefully have a much better childhood and adult life,” Professor Coates said.

“The islet auto-transplant should significantly improve his chances of avoiding diabetes, which would have been the inevitable consequence if he had had his pancreas removed otherwise.”

Acknowledgements: The surgery was the result of significant collaboration between WCH, Flinders Medical Centre and Royal Adelaide Hospital surgeons and staff working in SA Health’s islet transplant program, as well as St Vincent’s Institute of Medical Research, Melbourne through the Australian Islet Transplant Consortium. The Islet auto transplantation program in South Australia is supported by funding from The Hospital Research Foundation.

*This media release was prepared by the Government of South Australia on Wednesday August 5 2015.

**Dr Balamurugan Appakalai is an international pioneer in islet cell isolation and Associate Professor of Surgery at the University of Louisville, Kentucky, US. He travelled to Australia to share his expertise in islet cell isolation for this procedure, with his trip funded by The Hospital Research Foundation.

In photo: Back row: l to r – Dr Tom Loudovaris, Cameron Kos, Dr Balamurugan Appakalai, Janine Kuehlich, Front: Lina Mariana and Allison Irvin