Pancreatic Center

National Pancreas Foundation Centers of ExcellenceChildren with acute recurrent or chronic pancreatitis can find hope at the Pancreatic Disorders Center at UPMC Children's Hospital of Pittsburgh. Here families will find a team of doctors who understand pancreatitis, have a wealth of experience caring for children who have this condition, and can answer the many questions families often have about it.

Madhura Phadke, MD, serves as the medical director for the Pancreatic Disorders Center. John Eisses, MD, PhD serves as the Scientific Research Director of the Pancreatic Disorder Center. Kate Ellery, DO, is co-director of the TPAIT Program.

What is Pancreatitis?

The pancreas has two important functions in the body: helping digest food and producing insulin, which the body needs to convert food into energy. In children with chronic pancreatitis, the pancreas does not properly do its job of helping digest food. Inflammation causes scarring of the pancreas and abdominal pain.

Children with chronic pancreatitis often need to be hospitalized or take strong pain medicines to control their pain. Many of them develop diabetes, a chronic disease in which the pancreas cannot make insulin.

For about 75 % of affected children, pancreatitis is hereditary, caused by a genetic mutation that disables an important pancreatic enzyme.

Total Pancreatectomy with Autologous Islet-Cell Transplantation (TPAIT)

The UPMC Children's Hospital of Pittsburgh is one of only a few centers in the United States with the expertise to offer this novel procedure, known as TPAIT, for children with acute recurrent or chronic pancreatitis. 

Patients who are possible candidates for TPAIT must undergo a pre-surgical evaluation to confirm that they are healthy enough to undergo the procedure and that the benefits outweigh the risks. In addition to blood tests and x-rays, the evaluation includes imaging with a CT (computed tomography) scan or an MRI (magnetic resonance imaging) scan, a glucose tolerance test to check how the patient’s body breaks down sugar, and more.

When the evaluation is complete, a committee of doctors reviews the patient’s medical record and the evaluation findings and recommends whether to proceed with the surgery.

*Referrals are required from a primary care physician and a pediatric gastroenterology specialist prior to TPAIT procedure.

What Happens During a TPAIT Procedure?

Highly skilled surgeons first remove the patient’s pancreas. (This is the “pancreatectomy” part of the procedure).

Next, the doctors extract the islet cells, special cells in the pancreas that make insulin, which the body needs to convert food into energy. In the final step of the complex procedure, the islet cells are given back to the patient by an infusion into the liver. (This is the “islet cell transplantation” part of the procedure. “Autologous” means the patient receives a transplant of his or her own islet cells.)

What Happens After Surgery?

After a TPAIT, patients must take pancreatic enzymes for the rest of their lives to enable them to digest food. Some patients develop diabetes and need to take insulin.

In follow-up studies of children who have had TPAIT, most experience pain relief and improved quality of life. After surgery, 10 percent of patients are diabetic and 30 percent require low-dose insulin therapy.

Are There Alternatives to TPAIT?

For patients who do not have hereditary pancreatitis, alternative procedures such as therapeutic endoscopy may relieve pain and improve function and quality of life. UPMC Children's Hospital of Pittsburgh is one of only a few centers in the country offering therapeutic endoscopy to children with pancreatitis.

Is Children’s Involved in Pancreatitis Research?

Researchers at UPMC Children's Hospital of Pittsburgh are actively involved in research aimed at developing new treatments for chronic pancreatitis in children. They are directing a laboratory study looking at why certain genetic defects lead to chronic pancreatitis. Learning more about why children get pancreatitis will help doctors to find new and better ways of treating it.

Dr. Husain i also investigators in an international study, funded by the National Institutes of Health, to create a database of information about chronic pancreatitis in children. This study will help doctors better understand the causes, complications, and outcomes of chronic pancreatitis in children.

Referral Requirements

Referrals are not required from primary care physicians or other UPMC Children’s Hospital of Pittsburgh specialty services. Referrals for patients enrolled in managed care insurance plans may require authorization from the insurance provider and primary care physician.

All necessary referral and authorization forms must be received before the patient’s visit. Prior submission of medical records, imaging studies, and biopsy slides are recommended for optimal consultation.