Total Pancreatectomy with Islet Autotransplant

What is TPIAT?

TPIAT explanatory figure

Total pancreatectomy-islet autotransplant or TPIAT is a surgical option for people with debilitating chronic pancreatitis or recurrent acute pancreatitis. The procedure involves the removal of the pancreas (total pancreatectomy or TP). Removing the pancreas removes the inflammation and scarring causing pain in chronic pancreatitis. However, this process also removes the islet cells, cells responsible for producing insulin to regulate blood sugar. Through a highly specialized procedure called islet autotransplant ("IAT"), we isolate these islets, and infusion them back into the liver, in order to prevent or reduce the severity of post-pancreatectomy diabetes.  In most cases, the islet cells are able to produce insulin in this new location, and some patients come off insulin entirely at least for some time after the procedure.

TPIAT is not the 'first step' in treating pancreatitis. TPIAT is considered for patients who have significant pain or impaired quality of life despite other medical treatment and/or endoscopic treatments.