New transplant surgery chief plans pancreas, islet transplants
Already, Upstate University Hospital is known for kidney transplant expertise, and Gruessner says a good number of people whose kidneys have failed due to diabetes mellitus would also benefit from a new pancreas. The new pancreas would not only protect the newly transplanted kidney but also halt or reverse the secondary diabetic complications and rend the patient non-diabetic and insulin-free.
Some patients would have both organs transplanted at the same time. Others would likely undergo pancreas transplant alone to preserve their kidney function or after a previous kidney transplant to prevent failure of the transplanted kidney due to ongoing diabetes.
Diabetes is the most common cause of end stage kidney disease or renal failure. “Rather than waiting until the kidney fails,” Gruessner says, “you may want to be proactive and go for a pancreas transplant.” A functioning pancreas transplants remains the only treatment option that achieves insulin-independence long term.
He says surgeons in the United States perform about 1,000 pancreas transplants per year and only about 35 in all of New York State. He hopes to increase those numbers starting in 2016.
This year already 70 kidney transplants have been performed at Upstate, the highest number ever. At least two more were scheduled for December.
Hear an interview about kidney transplants with Rainer Gruessner, MD.
Gruessner came to Upstate in September from the University of Arizona, where he built a successful multivisceral transplant program, in which three or more abdominal organs are transplanted en bloc. He and his team also performed the first fully robotic removal of a native pancreas and simultaneous islet auto-transplant in a patient with chronic pancreatitis.
He expects to be able to offer islet transplants at Upstate in the future as well, for two distinct patient populations. The first group are patients with chronic pancreatitis and intractable pain who will undergo complete removal of the pancreas and a simultaneous islet transplant so that the patient does not require insulin. This islet “auto” transplant is covered by most insurance companies.
The second group are patients with brittle or labile insulin-dependent diabetes mellitus. Since the results of islet transplants trail those of pancreas transplants, these islet “allo”transplants are currently not covered by most insurance companies.
Gruessner‘s medical degree is from the Johannes-Gutenberg-University in Mainz, Germany. He obtained the habilitation, the equivalent of a doctorate, from the Philipps-University in Marburg, Germany. He completed his general surgery training at the same institutions and then a fellowship in transplantation surgery at the University of Minnesota from 1987 to 1989.
He made many significant contributions to the field of transplantation during his early academic career at the University of Minnesota, including a preemptive liver transplant to an infant with a rare metabolic disorder called oxalosis and creation of a standardized technique for intestinal transplantation from a living donor.
Gruessner was part of the teams that performed the world‘s first split pancreas transplants and the world‘s first pancreas allotransplant after complete removal of a patient‘s native pancreas.
In Arizona, he was chairman of the department of surgery from 2007 to 2014. He has edited three textbooks, written more than 80 textbook chapters and more than 300 medical journal articles.
Gruessner is accepting new adult and pediatric patients for all types of abdominal transplants – kidney, pancreas, islet, liver and intestine. Eventually, he wants to add liver and intestine to the transplants performed at Upstate. He is also accepting patients with chronic pancreatitis for evaluation of total pancreatectomy and islet auto-transplantation.
Reach him through transplant services at 315-464-5413.
This story appears in the January issue of Physicians Practice.
Hear an interview about kidney transplants with Rainer Gruessner.