Specialized UC Surgery Cures Cleveland Teen of Chronic Pancreatitis

For teenagers, junk food is typically a way of life. 

However, Westlake, Ohio, resident Courtney D’Avino, 18, wasn’t able to enjoy all of the bad foods that taste so good—or really any food—without experiencing intense pain until just a few years ago.

"It all started when I was 15 and took a trip with my family to Disney World; I had an ice cream cone, and I thought I was going to die,” she says. "I thought maybe it was just cramps, but after hours of just lying on the floor in a ball, I realized that this wasn’t normal.”

She was diagnosed with chronic pancreatitis, which was not a complete surprise as her sister Paige, who is now a student at the University of Cincinnati, also suffered from the same condition. It was Courtney’s diagnosis that led to genetic testing, confirming hereditary pancreatitis. Paige, thankfully, lives a pain-free life, but for Courtney, this awful disease was presenting in its worst way.

D’Avino says she spent the next two years in excruciating pain daily and on oxycodone, taken after every meal, to ease the debilitating pain that followed after eating—and if that wasn’t difficult enough, episodes started to occur even unrelated to food intake.

"I was in and out of the hospital eight times over the course of a year, and I had a lot of bad reactions to medication they were trying to give me for the pain,” she says, adding that she missed a lot of school and was unable to participate in normal teen activities.

The hospital to which she was admitted showed great care, but in the end, physicians there could only deal with managing her pain and keeping her hydrated. 

"My parents were tired of seeing me suffer, and began searching for answers on the Internet, which is what led us to Dr. Syed Ahmad at UC.”

The D’Avinos became aware of a surgical option that held the potential of eliminating her pain. The surgery could   mean challenges associated with diabetes, but pain relief and pain medicine elimination were the primary goals.

Ahmad, director of the UC Pancreatic Disease Center, which is part of the UC Cancer Institute, and a UC Health surgeon, was able to remove her pancreas with autologous islet cell transplantation, a highly specialized surgical procedure that can "cure” chronic pancreatitis. Only a half-dozen hospital systems in the United States offer this procedure.

"Patients with chronic pancreatitis are quite debilitated,” says Ahmad, a professor in the UC College of Medicine’s department of surgery, adding that many of them only have strong and sometimes addicting pain medicine to help soothe the discomfort. 

 

Located behind the lower part of the stomach, the pancreas is a small organ that produces insulin to control blood sugar levels and enzymes that help the body process and use food. Insulin is produced in the pancreas by cells called the islets of Langerhans (Islets), which are made of several types of cells including insulin-producing beta cells. This hormone helps the body use glucose (sugar) for energy. If the body does not produce enough insulin or has trouble using it properly—causing glucose to build up in the blood—the patient will develop diabetes.

The advent of islet transplantation allows surgeons to remove the pancreas and possibly prevent or minimize diabetes.

During a pancreatectomy with autologous islet cell transplantation, the patient’s pancreas is completely removed. The organ is then taken to a laboratory where a specialized process is used to remove the islet cells. The cells are then purified, processed and transplanted in the patient’s liver. There, the islets take residence and function as they would have in the pancreas.

D’Avino’s pancreas cells were processed in the cellular therapy lab at Hoxworth Blood Center, which has been managing this process for UC Health surgeons for many years.

Unfortunately, it was necessary for D’Avino to become insulin dependent following the surgery, but this, along with a longer recovery process, is a small price to pay for living a normal life, she says.

She’s now enjoying being a "normal teenager” and trying to determine what she wants to study in college and discover new hobbies.

"It’s so good to eat without pain,” she adds. "I love food so much—I tell everyone I’m in a relationship with food.” She says managing her diabetes is a challenge, but the surgery has dramatically improved her quality of life.

"We’re so happy to have found Dr. Ahmad and the team at UC,” says Patti D’Avino, Courtney’s mother. "We couldn’t have asked for a better experience, and now, Courtney is able to live life like every 18-year-old should. We also know that Dr. Ahmad and his team, including transplant nurse and our key contact during follow-up,  John Brunner, are always there for us.”