CPT® Code 0141T | Case2Code

Code deleted. See 48999

Official Description

Pancreatic islet cell transplantation through portal vein, percutaneous

Common Language Description

Pancreatic islet cell transplantation is a specialized medical procedure aimed at treating individuals with type I diabetes who experience significant challenges in managing their blood sugar levels through insulin therapy alone. This procedure involves the extraction of islet cells, which are clusters of cells within the pancreas responsible for producing insulin. These cells, known as the Islets of Langerhans, are harvested from a donor pancreas and subsequently purified in a laboratory setting. Once prepared, the islet cells are introduced into the patient's liver via the portal vein, a major blood vessel that carries blood from the digestive organs to the liver. The goal of this transplantation is to enable the islet cells to attach to the liver and begin producing insulin, thereby improving the patient's ability to regulate blood sugar levels. The procedure is characterized as minimally invasive, particularly when performed percutaneously, which involves inserting a needle through the skin to access the portal vein. Alternative methods for this procedure include open dissection and laparoscopic techniques, which also target the portal vein. While pancreatic islet cell transplantation can significantly enhance the quality of life for patients, it is important to note that a single infusion of islet cells may not be sufficient to eliminate insulin dependence, and multiple transplant infusions may be necessary to achieve optimal results.

1. Indications

Pancreatic islet cell transplantation is indicated for patients with type I diabetes who have difficulty achieving stable blood sugar control through conventional insulin therapy. This procedure is particularly considered for individuals who experience severe hypoglycemic episodes or have other complications related to diabetes that significantly impact their quality of life.

Type I Diabetes Patients diagnosed with type I diabetes who struggle with blood sugar management despite insulin therapy.
Severe Hypoglycemia Individuals experiencing recurrent severe hypoglycemic episodes that pose a risk to their health and safety.
Diabetes Complications Patients with diabetes-related complications that affect their overall health and well-being.

2. Procedure

The procedure for pancreatic islet cell transplantation involves several critical steps to ensure the successful transfer of islet cells into the patient's liver.

Step 1: Donor Islet Cell Harvesting The first step involves the surgical removal of the pancreas from a deceased donor. The pancreas is then processed in a laboratory to isolate and purify the islet cells, which are essential for insulin production.
Step 2: Preparation of Islet Cells Once harvested, the islet cells undergo a purification process to remove any non-islet tissue and ensure that only viable islet cells are used for transplantation. This step is crucial for maximizing the chances of successful engraftment.
Step 3: Transplantation via Portal Vein The purified islet cells are then injected into the patient's liver through the portal vein. This can be performed using a percutaneous approach, which is minimally invasive, or through open dissection or laparoscopic techniques, depending on the clinical scenario and the surgeon's preference.
Step 4: Monitoring and Follow-Up After the transplantation, the patient is closely monitored for signs of islet cell function and any potential complications. Follow-up care is essential to assess the success of the procedure and determine if additional infusions are necessary.

3. Post-Procedure

Post-procedure care for patients who have undergone pancreatic islet cell transplantation includes regular monitoring of blood sugar levels to evaluate the function of the transplanted islet cells. Patients may require ongoing insulin therapy, especially if the islet cells do not achieve full functionality. Additionally, patients will need to be monitored for potential complications, such as rejection of the transplanted cells or infection. Long-term follow-up is critical to assess the need for further transplant infusions and to manage any diabetes-related health issues that may arise.

Short Descr	PERQ ISLET TRANSPLANT
Medium Descr	PNCRTC ISLET CELL TRNSPLJ PORTAL PERQ
Long Descr	Pancreatic islet cell transplantation through portal vein, percutaneous
Status Code	Not Valid for Medicare Purposes
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Discontinued Code
Type of Service (TOS)	2 - Surgery
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	99 - Other OR gastrointestinal therapeutic procedures