Pancreatectomy involves the surgical removal of all or part of the pancreas, which may be required for the treatment of a variety of conditions, such as benign pancreatic tumors, pancreatic cancer, and pancreatitis.

Total Pancreatectomy

Our leading indication is for the treatment of severe diabetes following Total Pancreatectomy (TP).

Diabetes of the Exocrine Pancreas (DEP) has long been recognized as a distinct form of diabetes. In contrast to the more common type 1 and type 2 diabetes, patients with DEP have an underlying disease of the pancreas. Examples of these diseases include Chronic Pancreatitis (CP), trauma/pancreatectomy, neoplasia, cystic fibrosis, hemochromatosis, and fibrocalculous pancreatopathy. Some CP patients require total pancreatectomy (TP) to manage intractable pain. The incidence of diabetes following TP is 100%, resulting in immediate and lifelong insulin-dependence with loss of both endogenous insulin secretion and that of the counter-regulatory hormone, glucagon. Glycemic control after TP is notoriously difficult with conventional insulin therapy due to complete insulin dependence and loss of glucagon-dependent counter-regulation. Patients with this condition experience both severe hyperglycemic and hypoglycemic episodes.

As a means of preventing the likelihood of severe recurrent hypoglycemia following TP, researchers at the University of Minnesota School of Medicine pioneered in 1977, the first Total Pancreatectomy with Islet Autologous Transplant (TP-IAT). Although TP-IAT is considered the standard of care following TP, it is not always a feasible treatment due to insufficient quantity of potential functional harvested islets. Allogeneic islet cell transplantation provides an alternative treatment for patients that have developed hypoglycemia-prone type 1 diabetes, but this is not a realistic option for TP patients because the extreme shortage of donor islet tissue has limited islet transplantation to a very small number of patients with type 1 diabetes.

Orgenesis has developed a novel technology, utilizing liver cells as a source for Insulin Producing Cells (IPCs) as replacement therapy for islet transplantation. IPCs are derived from the liver cells that are taken by needle sampling from the patient to be treated. These liver cells are converted into functional glucose-regulated IPCs and returned to the patient by injection into the liver or possibly other sites. IPCs are intended as a cell replacement therapy for the treatment of patients with severe hypoglycemia-prone diabetes resulting from total pancreatectomy due to chronic pancreatitis or other rare conditions requiring TP.