December 15th, 2009
05:49 PM ET

Landmark trauma surgery was a collaborative effort

By Val Willingham
CNN Medical Producer

On November 21, Senior Airman Tre Porfirio was struck in the gut by three high velocity bullets while serving in Afghanistan. Porfirio, from St. Mary's, Georgia, was seriously injured; his entire digestive system was in danger of shutting down. During two operations in combat hospitals, surgeons removed his gallbladder along with portions of his large and small intestines, part of his stomach and a large section of his pancreas.
Porfirio was flown back to the United States immediately after emergency surgery, and taken to Walter Reed Army Medical Center, in Washington, D.C.

Col. Craig Shriver, chief of general surgery at Walter Reed, knew he had to remove the airman's remaining pancreas, which was found to be damaged beyond repair. "The optimal procedure at this point was to remove his entire remaining pancreas to prevent further leakage of the pancreatic enzymes and control the bleeding, which could be fatal," said Shriver. "We knew that the procedure would lead to the most severe and life-threatening form of diabetes, which tends to be very brittle and difficult to control in this type of situation.”

In an effort to save Porfirio from severe diabetes, Shriver turned to other surgeons for suggestions. Dr. Rahul Jindal, a transplant surgeon also at Walter Reed, had training and experience in islet cell transplantation, which is considered the best hope for curing diabetes. In islet cell transplantation, the insulin-producing islets are taken from a donor pancreas, treated and then put in the patient's liver where they begin to produce insulin for the body, even if there is no pancreas. In this case, the islet cells would come from Porfirio's own pancreas.

"Isolation and purification of pancreatic islets is a very intricate procedure, which requires a specialized laboratory, and there are only a few such facilities in the United States," said Jindal.

But Jindal knew of the perfect facility for the job; he turned for help to the Diabetes Research Institute at the University of Miami Miller School of Medicine. The director of the institute, Dr. Camillio Ricordi, developed the method for isolating the islet cells from the pancreas and was considered a pioneer in the field. Ricordi immediately agreed to help, noting that he would do "anything to help a wounded warrior."

Doctors at Walter Reed then proceeded to remove the remaining portion of Porfirio’s pancreas, packed it in ice and sent it to Miami.

On Thanksgiving Day, just five days after Porfirio's initial injury, the cell processing team at the Diabetes Research Institute spent six hours performing the islet cell isolation and purification procedure. "More than 220,000 purified islets were then suspended in a specialized cold solution and flown back to Walter Reed,” said Ricordi.

That afternoon, on that very same Thanksgiving Day, the islet cells were injected into Porfirio’s liver with Ricordi and his team coordinating the procedure with surgeons at Walter Reed via an Internet connection, a sort of high-tech telemedicine event.

In the three weeks since being wounded in Afghanistan, Porfirio has undergone 11 surgeries and, according to doctors, is "doing well." In a press conference held Tuesday at Walter Reed Medical Center, surgeons noted that there was evidence of the airman’s islet cells functioning in his liver less than one week after surgery; 15 days after the procedure, the transplanted islet cells were functioning in the normal range. His physicians say as time goes on, the islet cells in the liver will get stronger; when that happens, Porfirio's insulin requirement is expected to decrease. And although he'll still have a form of diabetes, the complication won't be as dangerous and he'll have a better quality of life.

Doctors from both the University of Miami Miller School of Medicine and surgeons at Walter Reed believe this transplantation is the first of its kind in a wounded soldier. They hope the success of the procedure will allow for more cases of islet cell transplantation in military personnel, as more of our fighting men and women return from war with injuries like those of Senior Airman Porfirio.

« Previous entry
soundoff (270 Responses)
  1. Chris

    Amazing! Best wishes to Airman Porfirio for a speedy recovery

    December 16, 2009 at 01:26 | Report abuse | Reply
  2. Valerie

    My Mother is a diabetic and a leap in science that helps increase the quality of life of diabetics is good. I laude the efforts of both groups of doctors at Walter Reed and the University of Miami Miller School of Medicine. Great work! As a military veteran, myself, I would like to thank SrA Porfirio for his sevice. Good luck on the road to recovery!

    December 16, 2009 at 07:16 | Report abuse | Reply
  3. Shawn

    ...and people say military medicine is not worth its weight. Ha! This is absolutely outstanding!

    I keep you in my thoughts SrA Porfirio; you're a testament to the strong will that our Airman, much less all our folks in the Armed Services, to succeed in the face of adversity. May your recovery be swift!

    Sgt. E

    December 16, 2009 at 09:49 | Report abuse | Reply
  4. Dave

    Hey Tre, thanks for serving man. You are a hero and I am glad to hear you are doing well. Hang in there man, we are all pulling for you.

    December 16, 2009 at 11:59 | Report abuse | Reply
  5. Yahbut

    Wow! What an amazing story!

    I didn't think people could live without a pancreas.

    Now this is the kind of news I'd like to hear more about.

    Congratulations to all the doctors and other medical personnel involved.

    This is what the United States is all about. This is the type of story that makes me so proud of our country.

    My thanks to the serviceman for what he has given for freedom. We will always owe him a debt of gratitude.

    Thanks to all of you for making this a happy day for me.

    December 16, 2009 at 12:10 | Report abuse | Reply
  6. Molly

    This is amazing. I thought the body normally couldn't function without the pancreas. I'm wondering if we're seeing a sneak peek at future treatment for diabetes and maybe even pancreatic cancer. Bravo!

    December 16, 2009 at 13:18 | Report abuse | Reply
  7. ERIKA

    This is awesome news. Kudos to the medical team and swift healing to the Wounded Warrior.

    December 16, 2009 at 14:43 | Report abuse | Reply
  8. John Ryan MD FRCS FACS

    Excellent work by talented people and a wonderful logistical system.
    Full marks to all concerned.

    John Ryan
    Professor.Sanford S

    December 16, 2009 at 20:01 | Report abuse | Reply
  9. AllenB

    This is the way our military members and veterans should be treated. Nothing but the best and all obstacles removed. Great job all involved.

    December 17, 2009 at 01:18 | Report abuse | Reply
  10. Jeannette Vance

    What an amazing process. I pray SRA Porfirio continues to get better.

    December 17, 2009 at 10:54 | Report abuse | Reply
  11. avenuto

    pretty amazing medicine

    December 17, 2009 at 11:12 | Report abuse | Reply
  12. SSgt Corey

    It is so great to hear about the advances in medical science that allows doctors to heal our fellow service members. My hope is that SrA Porfirio can return to service if he desires.

    December 17, 2009 at 14:07 | Report abuse | Reply
  13. David Hornsby

    Just wanted to say thank you to all the Doctors that helped Tre out. I was stationed with him in Afghanistan when this all happen. He's a good and strong soldier. My prayers are to him and his family. I pray for a full recovery. Take care Tre!!!

    SSgt Hornsby

    December 17, 2009 at 15:15 | Report abuse | Reply
  14. Andy hoffman

    Amazing. I hope this can become the norm for people who lose their pancreas!!

    – A

    December 18, 2009 at 07:20 | Report abuse | Reply
  15. Esky

    I can't imagine what kind of courage it must have taken Tre to fight his way through this severe wound. Proud to serve alongside young Americans like him. /salute

    Sgt. EP

    December 18, 2009 at 13:52 | Report abuse | Reply
  16. Claudia Halpain

    This is an amazing story and I want to wish Sr. Airman Porfirio a speedy recovery and I want to wish him and his family a Healthy and Happy New Year!!!!!!!!!!!

    December 18, 2009 at 15:46 | Report abuse | Reply
  17. CSM(r) Tom Detchemendy

    HO AH. Way to go. Kudos to all involved including the patient. You all could have been home with your families and put this off until later. I am humbled and I salute you for taking care of one of my 'soldiers'.

    December 18, 2009 at 15:47 | Report abuse | Reply
  18. Okechukwu Nnaeto

    The US and their science will never stop to stop to amaze me. What a wonderful procedure! Kudos to all that were involed.

    December 24, 2009 at 02:06 | Report abuse | Reply
  19. John Pitman

    God bless those doctors!

    February 28, 2010 at 17:36 | Report abuse | Reply
  20. video editing software

    You are not right. I suggest it to discuss.

    July 23, 2010 at 18:03 | Report abuse | Reply
  21. web

    Sustain the exceptional work !! Lovin' it!
    web http://nfactor.org/members/anne95k483357/activity/162949/

    September 7, 2016 at 06:28 | Report abuse | Reply
  22. وك لوحات الموردين

    http://wooddeck.ga/eco/2986.htmlالجدار لوحات الحائط الخشب الحبوب الخشبية
    وك لوحات الموردين http://wooddeck.ga/cheap/2108.html

    November 27, 2017 at 03:09 | Report abuse | Reply
  23. KbrgMile

    best female viagra brand can i buy sildenafil over the counter in uk pfizer viagra for sale

    November 24, 2020 at 04:43 | Report abuse | Reply
  24. FmsgEncox

    se una ragazza prende viagra viagra acid reflux topix viagra online

    November 24, 2020 at 11:55 | Report abuse | Reply
  25. JsweCrulk

    pfizer online viagra viagra pills price canada viagra tablet india

    November 25, 2020 at 02:51 | Report abuse | Reply
  26. DbsfZisse

    how to get viagra in us viagra 50mg online order viagra generic wholesale

    November 25, 2020 at 15:16 | Report abuse | Reply
  27. KbrgMile

    where to buy sildenafil online with paypal viagra cost canada where can i get sildenafil 100mg

    November 26, 2020 at 07:05 | Report abuse | Reply
  28. FdbvZisse

    sildenafil 20 mg tablets cost viagra coupon canada sildenafil generic buy

    November 26, 2020 at 13:29 | Report abuse | Reply
  29. DbsfZisse

    generic viagra canada viagra 100 mg best price in india where to buy female viagra australia

    November 26, 2020 at 20:18 | Report abuse | Reply
  30. FmsgEncox

    es bueno tomar viagra a los 20 aГ±os viagra salvador bahia comprar viagra lima

    November 28, 2020 at 02:55 | Report abuse | Reply
  31. JgscCrulk

    politics dissertation best essay writer company speech writing essay

    November 28, 2020 at 07:30 | Report abuse | Reply
  32. FqfEncox

    write a good research paper basics of essay writing guidelines for writing an essay

    November 28, 2020 at 12:32 | Report abuse | Reply
  33. FgsZisse

    write my paper for me cheap essay help service get homework done fast

    November 28, 2020 at 23:36 | Report abuse | Reply
  34. KwgdMile

    thesis assistance help writing paper history of essay writing

    November 29, 2020 at 10:09 | Report abuse | Reply
  35. FtghEncox

    college essay visiting family recommendation research paper essays on canadian writing

    November 29, 2020 at 22:07 | Report abuse | Reply
  36. JgscCrulk

    writing thesis statements dissertation online 123 help me free essay code

    November 30, 2020 at 08:02 | Report abuse | Reply
  37. FnsbEncox

    george orwell essay on writing writing a great essay good powerpoint presentations

    November 30, 2020 at 12:08 | Report abuse | Reply
  38. DvscZisse

    best homework college online help the help movie analysis essay differentiation of trigonometric functions homework

    November 30, 2020 at 18:23 | Report abuse | Reply
  39. FsfEncox

    2 paragraph essay writer for cheap solve my physics homework exceptional college essays

    December 1, 2020 at 03:22 | Report abuse | Reply
  40. FtghEncox

    online help with chemistry homework essay writing definition wedding speech writing service

    December 1, 2020 at 11:47 | Report abuse | Reply
  41. KwgdMile

    buy dissertation online essay for college dissertation proposal literature review

    December 1, 2020 at 13:57 | Report abuse | Reply
  42. FnrdEncox

    generic viagra buy low cost viagra generic genric viagra

    December 1, 2020 at 16:22 | Report abuse | Reply
  43. FgsZisse

    perfect cover letter australian assignment help students assignment help

    December 1, 2020 at 17:26 | Report abuse | Reply
  44. FnrhEncox

    viagra effects on men viagra 100 mg purchase viagra in usa

    December 1, 2020 at 17:58 | Report abuse | Reply
  45. DvscZisse

    help with writing a cover letter importance of college essay ivy league college essays

    December 1, 2020 at 23:48 | Report abuse | Reply
  46. FqfEncox

    paper writing website custom writing service writing a wedding speech

    December 2, 2020 at 05:36 | Report abuse | Reply
  47. FsfEncox

    why is essay writing important where can i buy essays help me write a thesis

    December 2, 2020 at 16:37 | Report abuse | Reply
  48. FnrdEncox

    viagra super active 100mg pills viagra or cialis or levitra trial viagra time of action

    December 3, 2020 at 18:05 | Report abuse | Reply
  49. FnrhEncox

    buying viagra in canada cheapest place to buy viagra viagra prix

    December 3, 2020 at 18:53 | Report abuse | Reply
  50. FqbfEncox

    viagra vs levitra vs cialis reviews where to get generic cialis without prescription low cost cialis

    December 8, 2020 at 17:25 | Report abuse | Reply
1 2 3 4 5 6

Leave a Reply to FmsgEncox


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

« Previous entry
About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.