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 (282 Responses)
  1. KbbgMile

    buying viagra on line Avalide but viagra overnight delivery http://erectilejyzd.com/ – canada pharmacy online orders ’

    January 31, 2021 at 15:18 | Report abuse | Reply
  2. JbbvEncox

    meds online canadian pharmacy review online pharmacy busted

    February 3, 2021 at 11:26 | Report abuse | Reply
  3. LbsxEncox

    birth control generic viagra sildenafil citrate online pharmacies in usa

    February 3, 2021 at 23:45 | Report abuse | Reply
  4. FqhhEncox

    buy prescription drugs online price prescription drugs drug price

    February 4, 2021 at 18:08 | Report abuse | Reply
  5. AhkdEncox

    walgreens online pharmacy canadianpharmacy northwest pharmacy/com

    February 5, 2021 at 21:01 | Report abuse | Reply
  6. JbnbCrulk

    online prescription drugs canadian pharmacy world price prescription drugs

    February 6, 2021 at 02:17 | Report abuse | Reply
  7. KbcxMile

    walmart pharmacy price check skin care national pharmacies online

    February 6, 2021 at 07:14 | Report abuse | Reply
  8. zortilonrel

    Thanks for the marvelous posting! I certainly enjoyed reading it, you're a great author.I will be sure to bookmark your blog and will often come back down the road. I want to encourage continue your great work, have a nice day!


    February 7, 2021 at 07:53 | Report abuse | Reply
  9. zortilo nrel

    Hmm it seems like your site ate my first comment (it was extremely long) so I guess I'll just sum it up what I wrote and say, I'm thoroughly enjoying your blog. I too am an aspiring blog blogger but I'm still new to everything. Do you have any helpful hints for first-time blog writers? I'd really appreciate it.


    February 7, 2021 at 08:30 | Report abuse | Reply
  10. zortilo nrel

    Thank you for another informative website. The place else could I am getting that type of information written in such a perfect way? I have a undertaking that I'm simply now running on, and I've been on the look out for such info.


    February 7, 2021 at 18:19 | Report abuse | Reply
  11. AqcfTeneseelt

    how to buy cialis online canadian cialis 200 mg. levitra vs cialis

    February 8, 2021 at 05:18 | Report abuse | Reply
  12. FvfcZisse

    viagra using paypal buy viagra thailand fast shipping viagra cheap

    February 8, 2021 at 21:45 | Report abuse | Reply
  13. vasúti szállítmányozás Europa-Road Kft.

    There are definitely loads of particulars like that to take into consideration. That could be a great level to deliver up. I provide the ideas above as common inspiration however clearly there are questions like the one you carry up where a very powerful factor will probably be working in sincere good faith. I don?t know if greatest practices have emerged around issues like that, but I am positive that your job is clearly identified as a good game. Both girls and boys feel the impact of just a moment’s pleasure, for the remainder of their lives.


    February 9, 2021 at 04:09 | Report abuse | Reply
  14. Europa-Road gépszállítás

    I got what you intend, thankyou for posting.Woh I am delighted to find this website through google.


    February 9, 2021 at 04:52 | Report abuse | Reply
  15. Fókuszpályázat

    You are a very clever person!


    February 9, 2021 at 06:19 | Report abuse | Reply
  16. JbbnEncox

    cialis pierde efecto superiore al cialis cialis acheter belgique

    February 10, 2021 at 09:11 | Report abuse | Reply
  17. NncsZisse

    viagra on line\' canadian family pharmacy canadianpharmacyusa24h

    February 10, 2021 at 13:18 | Report abuse | Reply
  18. LabxEncox

    cialis durata effetti cialis promotional codes buy viagra cialis uk

    February 10, 2021 at 22:27 | Report abuse | Reply
  19. FqbbEncox

    cash advance seminole tx can i get away with not paying a payday loan cash advance loan montel williams

    February 11, 2021 at 16:14 | Report abuse | Reply
  20. AhbzEncox

    avon magix cashmere advanced liquid foundation review payday loans uk no brokers bad credit cash advance in rittman ohio

    February 12, 2021 at 23:09 | Report abuse | Reply
  21. JbnvCrulk

    payday advance loans omaha 50000 cash loan payday loans close to me

    February 13, 2021 at 03:54 | Report abuse | Reply
  22. KvaxMile

    payday loans reported credit bureau payday advances brampton long term loans money supermarket

    February 13, 2021 at 06:10 | Report abuse | Reply
  23. AbcfTeneseelt

    viagra super active,free shipping viagra sydney overnight viagra delivery usa

    February 14, 2021 at 08:30 | Report abuse | Reply
  24. plaquenil 400 mg

    is erectile dysfunction dangerous plaquenil brand name erectile problems

    February 16, 2021 at 21:25 | Report abuse | Reply
  25. FbsgZisse

    where to buy generic cialis ? cialis cheap cialis purchase

    February 16, 2021 at 23:23 | Report abuse | Reply
  26. NbnhZisse

    prescription generic viagra http://vigedon.com/ sildenafil 12.5 mg

    February 18, 2021 at 05:44 | Report abuse | Reply
  27. tadalafil max dose

    tadalafil tablets 5mg tadalafil daily use tadalafil e20 pill

    February 24, 2021 at 04:55 | Report abuse | Reply
  28. KndnMile

    buy viagra online amazon 20mg viagra how well does viagra work

    February 28, 2021 at 11:34 | Report abuse | Reply
  29. wiki.klid.dk

    I really like your blog.. very nice colors & theme. Did you design this website yourself or did you hire someone to do it
    for you? Plz respond as I'm looking to design my own blog
    and would like to know where u got this from.


    My web site: 918kaya game (wiki.klid.dk)

    March 9, 2021 at 11:18 | Report abuse | Reply
  30. 918kaya trick

    Heya i'm for the primary time here. I found this board and I
    to find It truly helpful & it helped me out much. I hope to
    give something back and help others like you aided

    Also visit my blog 918kaya trick

    March 17, 2021 at 22:32 | Report abuse | Reply
  31. JvqqEncox

    https://dissertationahelp.com/ – theses and dissertations dissertation review dissertation writing service uk search dissertations

    March 22, 2021 at 13:48 | Report abuse | Reply
  32. LmoppEncox

    http://essaywriteris.com/ – write my essay for money who can write my essay for me best essay writer who can write my essay for me

    March 23, 2021 at 01:02 | Report abuse | Reply
  33. FbshEncox

    https://thesisacloud.com/ – phd thesis writing thesis literature review writing your thesis phd thesis writing help

    March 23, 2021 at 09:50 | Report abuse | Reply
  34. AbgcEncox

    https://thesiswritingtob.com/ – phd thesis writing service thesis chapters good thesis statement thesis statement help

    March 24, 2021 at 08:38 | Report abuse | Reply
  35. Shera Bereda

    I truly appreciate this post. I’ve been looking all over for this! Thank goodness I found it on Bing. You have made my day! Thx again


    March 25, 2021 at 08:29 | Report abuse | Reply
  36. FbshEncox

    https://thesisacloud.com/ – thesis publishing online thesis how to write thesis proposal online thesis

    March 26, 2021 at 04:01 | Report abuse | Reply
  37. GrvCrulk

    [url=https://kloviagrli.com/]can you get viagra over the counter[/url] [url=https://vigedon.com/]canada viagra[/url] [url=https://llecialisjaw.com/]how many mg cialis should i take[/url] [url=https://jwcialislrt.com/]cialis reviews[/url] [url=https://jecialisbn.com/]cialis wiki[/url]

    March 26, 2021 at 11:51 | Report abuse | Reply
  38. BrfgMile

    https://ljcialishe.com/ – cialis 5mg side effects https://cialisvja.com/ – cialis over the counter 2018 https://viagraonlinejc.com/ – normal dose of viagra https://viagratx.com/ – do you need a prescription for viagra https://buycialisxz.com/ – buy cialis online safely

    March 26, 2021 at 17:27 | Report abuse | Reply
  39. AbgcEncox

    https://thesiswritingtob.com/ – good thesis thesis statement help thesis advice thesis to book

    March 27, 2021 at 03:17 | Report abuse | Reply
  40. FbshEncox

    https://thesisacloud.com/ – thesis paper writing thesis writing service п»їthesis master thesis writing service

    March 31, 2021 at 09:16 | Report abuse | Reply
  41. AbgcEncox

    https://thesiswritingtob.com/ – online thesis help help writing a thesis statement writing thesis thesis defense advice

    April 1, 2021 at 08:30 | Report abuse | Reply
  42. FbshEncox

    https://thesisacloud.com/ – thesisacloud.com thesis writing service reviews thesisacloud.com help with thesis writing

    April 8, 2021 at 02:39 | Report abuse | Reply
  43. AbgcEncox

    https://thesiswritingtob.com/ – thesiswritingtob.com doctoral thesis help thesiswritingtob.com phd thesis proposal

    April 9, 2021 at 01:46 | Report abuse | Reply
  44. recommended doseage of alprostadil suppository

    how to get alprostadil injection https://alprostadildrugs.com/ injectable drugs for erectile dysfunction

    April 12, 2021 at 13:33 | Report abuse | Reply
  45. canadian pharmacy cialis without prescription

    canadian pharmacy generic cialis https://canadacialisstore.com/ canadian pharmacy cialis without prescription

    April 14, 2021 at 00:01 | Report abuse | Reply
  46. mens ed pills

    is erectile dysfunction real https://canadaerectiledysfunctionpills.com/ how erectile dysfunction affects reproduction

    April 17, 2021 at 02:26 | Report abuse | Reply
  47. viagra canada by mail

    viagra without a doctor prescription in canada https://canadaviagrastore.com/ viagra without a doctor prescription in canada

    April 17, 2021 at 08:43 | Report abuse | Reply
  48. GvdbCrulk

    tadalafil 20mg review https://boxtadafil.com/ sildenafil or tadalafil

    April 22, 2021 at 23:47 | Report abuse | Reply
  49. buy vardenafil over the counter online

    vardenafil nortwest pharmacy https://vegavardenafil.com/ vardenafil prices

    April 23, 2021 at 07:16 | Report abuse | Reply
  50. AbdgEncox

    canada pharmacies without script https://canadianeve21.com/ Nexium

    April 23, 2021 at 11:37 | Report abuse | Reply
1 2 3 4 5 6

Leave a Reply to LrbsEncox


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.