Wright-Patt Airman has groundbreaking transplant surgery

  • Published
  • By Kristin Ellis
  • Walter Reed Army Medical Center
WASHINGTON --  In an unprecedented surgery, Walter Reed Army Medical Center and the University of Miami collaborated to perform the first pancreas islet cell transplant Thanksgiving Day on an airman whose pancreas was injured so severely in Afghanistan it had to be removed.

Senior Airman Tre Porfirio, a 21-year-old communications technician deployed from Wright-Patterson Air Force Base, Ohio, was shot three times in the back by an insurgent Nov. 21 while serving with an Army unit in Afghanistan. Seventy-two hours and 8,000 miles later, Porfirio was at Walter Reed with injuries so extensive it would require 11 surgeries to reconstruct his abdomen.

Porfirio was taken to the operating room where Col. Craig D. Shriver, chief of general surgery, found the pancreas damaged to the point it was leaking dangerous enzymes that were causing blood vessels and tissue to breakdown.

"The only possible course of action at the time was to remove the remainder of his pancreas which would predictably lead to a severe form of life-threatening and life-style-limiting diabetes," Shriver explained to reporters at a press conference Tuesday.

Risks for this type of diabetes include blindness, kidney failure, amputations, and strokes as well as daily insulin injections for the rest of his life.

That's when the surgical team called the University of Miami and put together a plan to ship the damaged pancreas to Florida to harvest the cells that produce insulin (called islet cells) and immediately ship them back to Walter Reed to be transplanted into Porfirio's liver. Over the last eight years of war, Walter Reed has seen only 28 pancreatic injuries and only one of this devastating nature.

All of this to be done overnight, the day before Thanksgiving.

"I knew who the main players were in this case," said Dr. Rahul Jindal, transplant surgeon. "I picked up the phone and called [Dr. Camillo Ricordi, chief of cellular transplantation, University of Miami] and, without hesitation, he said, 'For a wounded warrior, I'll bring my whole team.'"

"Being able to serve a wounded warrior who risked his life to defend us all, I can think of no better way to spend Thanksgiving," Ricordi said.

In islet cell transplantation, the insulin-producing islets are isolated from the donor pancreas and then reinfused in a patient's liver where they begin to produce insulin, doctors explained.

"You turn the liver into a double organ as it takes on the function of the pancreas," Ricordi said. "Normally when similar procedures are done for Type 1 diabetes, the cells come from another person, so you need immunosuppressant drugs to keep them alive. Since we were able to use his own cells, he won't need to be on anti-rejection drugs."

The University of Miami team spent six hours isolating the islet cells before they were suspended in a specialized cold solution and flown back to Walter Reed. Ricordi helped coordinate the transplant with the surgeons through an internet connection and on Thanksgiving Day, Porfirio's own cells were successfully injected into a vein to his liver. After spending 24 hours without a pancreas, Porfirio's blood tests show his harvested islet cells are functioning well, and he is gaining back his strength everyday.

"For anyone within a six-hour flight range of Miami, there is no reason any pancreas should ever be thrown away," Ricordi said.

Senior Airman Porfirio's commander at Wright-Patt, Lt. Col. Rick Johns, said despite the severity of his injuries, Tre is in great spirits.

Immediately after Porfirio arrived to Walter Reed, the Air Force arranged for his father Karl and a brother to be flown to his bedside. Lt. Col. Johns then joined Tre's best friend, Senior Airman Scott Cross to visit and encourage him, bringing along well wishes and prayers of the entire 88th Communications Group.

Johns said the charitable Luke's Wings organization is helping to provide transportation for Porfirio's dad, three brothers and girlfriend to be with him for the Christmas holiday.

"It's absolutely a miracle that he's alive and making this rapid progress," Johns said. "Tre is understandably a little tired of being poked and prodded, but he's a fighter. It was incredible to see him stand."

"I know Senior Airman Porfirio has been touched by the outpouring of support from his extended Air Force family," Johns said.

This week the St Marys, Ga. native took his first steps since being wounded. Johns said doctors have acknowledged the 6' 4" Airman's level of fitness has contributed to his remarkable recovery.

"I do believe the Air Force's PT [physical training] program played a major role in saving his life," Lt. Col. Johns said, noting all of the Airmen in his unit deploy and on any given day about a third are down range supporting joint warfighters. Johns added the squadron's regular group runs, aerobic and strength conditioning contributes to both camaraderie and the physical rigors of deployment.

At Wright-Patterson Air Force Base, Porfirio's job was to help maintain the Air Force's largest telephone switching network with over 26,000 lines.

Officials hope to be able to transfer Porfirio in the next couple of months from Walter Reed to Wright-Patterson Medical Center where he will continue his recovery.

(Courtesy of American Forces Press Service. Derek Kaufman from the 88th Air Base Wing Public Affairs Office contributed to this story.)