Kelsey Wise

Kelsey Wise was born three-and-a-half months premature, at just 1 pound and 13 ounces, with cerebral palsy.  Her mom, Tané, calls her the "miracle child" - a title that's stuck with her not so much because of her challenging start in life, but rather how she prevailed over the illness that caused her so much pain during the next eight years.

The 13-year-old girl entered University of Minnesota Children's Hospital, Fairview, in severe pain from a debilitating disease and left pain-free with a new outlook on life.  "He gave my daughter her life back," Tané says of David Sutherland, M.D., Ph.D., professor of surgery at the University of Minnesota, who treated Kelsey with a rare procedure performed at only a handful of academic hospitals, including the children's hospital.

At age 5, Kelsey was diagnosed with chronic pancreatitis, an ongoing inflammation of the pancreas.  The pancreas produces digestive enzymes, which help break down food, and insulin, which controls the level of sugar in the blood.  Kelsey's damaged pancreas gradually became unable to produce normal digestive enzymes and would eventually affect her production of insulin.

She had been fed intravenously since birth as a result of her digestive problems associated with the disease.  To help alleviate the extreme pain caused by the pancreatitis, her medical team in California delivered medication through a pump implanted in her abdomen.  Over the years, she continued to be treated with medications, but always with the caveat that she would never get better.

After years of trying to stave off the pain with medication and months of hospitalization, Kelsey's doctor suggested the family fly to the children's hospital to see Sutherland, who was showing promising results with a combination pancreatectomy (removal of the pancreas) and pancreatic islet cell transplant to counteract the loss of the insulin-producing pancreas.

Pancreatitis

Abdominal pain is a constant for patients who have chronic pancreatitis, says Sutherland.  Even after an operation to relieve obstruction of the pancreatic duct that may be the source of pain, some patients still require narcotic medication.  Other patients are not candidates for surgery and, as a result, must take narcotic pain relievers for the rest of their lives.

At several centers, surgeons are able to perform a pancreatectomy to help alleviate pain.  But because the operation results in the removal of most of all of the gland that produces insulin (the pancreas), all patients who have this procedure become diabetic and must take insulin for the rest of their lives to survive.

At the University of Minnesota Medical Center, however, Dr. Sutherland is able to perform an autotransplantation of islets after the pancreatectomy.  After the patient's pancreas is removed, pancreatic islets (which contain the cells responsible for releasing insulin into the bloodstream) are isolated from it.  The islets are then transplanted back into the patient.  Among 51 patients who had this procedure, about one-third became diabetic, one-third required only intermittent treatments of insulin, and one-third were completely diabetes-free, according to a recent study conducted by Sutherland and other physicians at the University of Minnesota's Diabetes Institute for Immunology and Transplantation (DIIT) and presented at the 2005 annual Clinical Congress of the American College of Surgeons.  About 85 percent of patients who have the procedure are pain-free, says Sutherland.

The "Court of Last Resort"

Tané had never heard of the procedure, Sutherland, or the hospital.  But the days of watching her daughter suffer- her small body weakening - were too much for her to bear.  In the back of her mind, Tané feared Kelsey would eventually succumb to an infection and die.  "We were in the court of last resort," she says.

The Wises flew to Minneapolis and wheeled 8-year-old Kelsey into Sutherland's exam room, not sure she'd even be a candidate for the procedure.  After all, she had cerebral palsy, was in a wheelchair, fed intravenously all her life and had been recently bedridden.  "By the time we saw Dr. Sutherland, our pediatrician thought she was at a point where we either needed to have the transplant or let her pass away," Tané recalls.  "She was in incredibly poor health."

They came in desperation.  They left with something they hadn't had in awhile - hope.  "Dr. Sutherland sees the value in all children.  He saw a girl with cerebral palsy in a wheelchair as deserving of this procedure.  Just because you're in a wheelchair doesn't mean you have to suffer every day," she says.  "As a person and a human being, he's wonderful."

Following the 13 1/2-hour surgery, Kelsey was at University of Minnesota Children's Hospital for three-and-a-half months with varying complications associated with her disease.

"Everybody at the hospital believed in my daughter and my family," Tané says.  She credits many for the exceptional care her daughter received, from the surgeons to the nurses to social worker Kathy Weck, who gave Kelsey a Barbie birthday cake and threw her a party for the ninth birthday she missed while comatose during recovery.

Available at Only a Few Academic Hospitals

The University of Minnesota Medical Center, Fairview and University of Minnesota Children's Hospital, where 20 to 30 pancreatectomies and autoislet transplants are performed every year, are among only a few academic hospitals in the United States that offer this treatment alternative for patients with pancreatitis.

"For patients who don't have diabetes before a pancreatectomy, there is often a tradeoff: they get diabetes in return for the relief of pain and getting off narcotics.  Almost every patient says nothing is worse than being on narcotics and still having pain," says Sutherland.

On the other hand, the transplantation of islet cells from the patient prevents diabetes for many patients.

When Kelsey left the hospital, she was pain-free and insulin-free.  "It's nothing short of a miracle," Tané says.  Before the operation, she was bedridden and on intravenous pain medications.  Now 13 years old, "Kelsey doesn't even take Tylenol.  And, this afternoon, she's going horseback riding, Tané says.  "The suffering stopped in Minneapolis.  We left that at the door of the hospital."

They left something else at the hospital - Kelsey's intravenous nutrition bags.  As a result of the procedure, Kelsey also began to eat on her own for the first time in her life.  "When Dr. Sutherland told us she wouldn't need intravenous nutrition after the procedure, we couldn't believe it," Tané says.  But, just before leaving the hospital, Kelsey threw away her last bag of intravenous nutrition.  "That was a huge turning point for us," Tané says.  "For eight-and-a-half years, Kelsey was fed intravenously.  Today, she had a cheeseburger and fries."  More than five years after the procedure, Kelsey remains pain-free and insulin-free.