Acute necrotizing pancreatitis

Treatment of acute necrotizing pancreatitis with stem cells

In 2012 Ukrainian Ministry of Health has approved usage of stem cells as a viable treatment of acute necrotizing pancreatitis.

Necrotizing pancreatitis is an extreme complication of acute pancreatitis. It may occur when pancreatitis is left untreated for a prolonged period of time and pancreas becomes extremely inflamed.

Inflammation leads to closure of ducts, therefore digestive enzymes can’t pass and “spill over” to the rest of the pancreas. In a way, pancreas then eats itself by destroying the pancreatic tissue, leading to necrosis. Untreated necrotizing pancreatitis then may lead to pancreatic abscess, sepsis and death.

There’s a popular perception that pancreatitis is exclusively a “drinker’s disease”, which is one of the leading causes of pancreatitis. However, there are many other processes who may lead to development of the disease, ranging from genetic component to infections to gallstones. Typical symptoms of pancreatitis include pain in the abdomen area, nausea and vomiting.

Treatment of acute necrotizing pancreatitis is two-fold: acute pancreatitis attack must be contained and already dead tissue must also be removed. Dead tissue may be removed with an endoscopic procedure to minimize risks, however, if the damage to the pancreas is significant, an open surgery may also be performed.

Surgeons of the P.L. Shupyk National Medical Academy of Postgraduate Education together with Institute of Cell Therapy and Center for Coordination of Transplantation of Organs, Tissue and Cells have developed an effective approach to treatment of necrotizing pancreatitis by utilizing cord blood and tissue transplants.

The essence of the approach is to transplant a specially prepared, cryopreserved sample of cord tissue which will facilitate reopening of inflamed pancreatic ducts, following the surgical removal of necrotic tissue. This also prevents formation of pancreatic cysts.

On the second day after the operation, the transplant is removed using a drainage system. The treatment regimen is then followed by daily administration of small doses of cord blood to stimulate regeneration processes and decrease inpatient care time.

This approach was then tested in a small-scale test, where 20 people with the diagnosis of necrotizing pancreatitis were treated with cord blood and tissue transplant, following surgical intervention. All showed favourable outcomes, with zero patients showing signs of pancreatic cysts following a six-months follow-up.

One patient who was not a part of the group during the test (but was diagnosed with necrotizing pancreatitis) has developed a respiratory distress with oxygen saturation dropping to 50%. Patient then was administered a quintuple dose of cord blood within 24 hours, which then followed by stabilization and improvement of SAT and V/Q stats.

The breath function and respiratory circulation recovered. Patient left the hospital without any complications 10 days after the first administration of cord blood stem cells.