Dr. Horacio L. Rilo, an international pioneer in islet cell transplantation for the treatment of diabetes, has been appointed professor of surgery and director of cellular transplantation at The University of Arizona's department of surgery. Rilo joins the UA to establish a clinical islet transplant program to treat patients with severe type 1 diabetes or with painful chronic pancreatitis.
As director of the Clinical Islet Transplant Program at the University of Cincinnati, Rilo spearheaded the development and management of its islet initiative and built one the most successful programs in the world. There he performed 118 islet cell procedures to avert diabetes in patients who suffer from severe pancreatitis or to treat patients with extreme type 1 diabetes. He has performed close to 170 clinical islet procedures during his career.
Arizona patients with severe chronic pancreatitis now will have the option of having an islet "autotransplant" after their total pancreatectomy, which involves removing the entire pancreas. Although a pancreatectomy usually is effective in relieving the debilitating pain in patients when all other treatments fail, it induces severe, permanent diabetes, requiring patients to take insulin shots or use an insulin pump for the rest of their lives.
During an islet autotransplant, the patient's own insulin-producing beta cells – contained in clusters called islets – are isolated from the removed pancreas and then the cells are put back into the patient’s liver, where they lodge in small blood vessels and release insulin.
An islet transplant for type 1 diabetes involves isolating islet cells from a cadaver donor's pancreas, then injecting the cells through the skin into the portal vein of the recipient's liver, where they start producing insulin. The procedure reverses diabetes, allowing many recipients to no longer need their blood glucose meters, pumps and syringes.
However, this procedure is performed on patients with severe, difficult-to-manage diabetes because recipients must take immunosuppressive medications the rest of their lives to prevent transplant rejection. Also, there is a shortage of donor organs to provide islet cells, as well as a lack of medical centers that can provide this technology.
“Dr. Rilo possesses one of the largest experiences in clinical islet transplantation in the world,” said Rainer Gruessner, professor and head of the UA department of surgery. “His expertise will help to establish the UA College of Medicine as one of the top programs in the country for transplantation surgery and for the treatment of diabetes.”
Rilo said he became interested early in his career in islet cell transplantation as a possible cure for insulin-dependent diabetes, a disease that affects more than 1 million Americans.
He was one of the first fellows trained by Dr. Camillo Ricordi, a pioneer in the islet field. “At the time, few researchers and clinicians believed in islet cell transplantation as a potential treatment and cure for diabetes,” explained Rilo. “I recognized the possibilities early on and focused my career for the past 18 years on treating patients with islet cell transplantation and in advancing the field of islet cell research and therapy in the fight to cure diabetes.”
Rilo received his medical degree from the University of Buenos Aires School of Medicine in Argentina, and completed his residency in general surgery at Buenos Aires Hospital. Rilo then completed a fellowship in liver transplantation in Sao Palo, Brazil. He moved to the United States in 1990 and completed a fellowship and worked as an assistant professor in transplantation at the University of Pittsburgh Transplantation Institute.
In 1996, he was recruited by the University of Chicago, where he worked as an associate professor and the director of cellular transplantation until he moved to Cincinnati in 1999.
He has published 120 articles and book chapters and serves on the editorial review boards of eight journals.
His research focuses primarily on the advancement of islet cell transplantation for the treatment of type 1 diabetes and chronic pancreatitis. These projects include improvements to the method he developed to isolate islet cells; investigation of alternative sites of implantation; expansion of adult-derived pancreatic duct cells into insulin producing cells; research into the cryopreservation of organs; and development of culture media and methods to store organs to promote oxygen diffusion.
Gruessner said, “Our vision is to build a Cellular Transplantation Institute at the UA College of Medicine under Rilo’s leadership. This institute would include not only islet cell transplantation, but also the transplanting of liver and muscle cells in patients who need a liver or heart transplant to serve as a bridge until an organ becomes available.”