MUSC's lab of healing

A medical team removed Robin Rabun's pancreas from deep inside her abdomen and placed the hand-sized organ into a blue Igloo cooler.

A scientist quickly carried the ice chest across the Medical University of South Carolina campus to a new clean lab.

In the ultra-sterile lab, researchers disintegrated her organ with enzymes to extract islet cells that produce insulin. Hours later, those cells were infused into her liver, where they should attach, grow and stabilize her blood sugar.

And her pancreas, the source of her crippling pain, was gone.

In addition to islet cell transplants, the clean lab is used to research cancer vaccines. A trial is already under way for a colon cancer vaccine, said Scientific Director Michael Nishimura, who manages the lab.

The lab is a collaborative effort among five MUSC entities — Hollings Cancer Center, General Clinical Research Center, Medical University Hospital Authority and the departments of pediatrics and surgery — and is designed to make tissues and cells for various patient therapies, said Dr. David Cole, chairman of surgery.

Air is blown out of the honeycomb of white rooms. A soft breeze can be felt around the entrance. The positive pressure and numerous filters keep the air clean. Sticky doormats capture dirt from soles before and after booties go on.

Rabun, 48, suffered from chronic inflammation of the pancreas, the organ responsible for insulin and the juices necessary to digest food.

The pain and nausea began after a hernia operation in 1994, the Aiken resident said. "It's hard to explain to people the nausea," Rabun said. "There's not a day you feel good. It wears you down."

Doctors can remove parts of the pancreas or the entire organ to alleviate symptoms. But life without a pancreas means living with a severe form of diabetes that can swing rapidly and without warning.

An islet transplant gives patients a chance to preserve those insulin-producing cells. And since the cells are harvested from the patient, the risk of rejection is nearly eliminated.

"I was nervous when I heard of the surgery," Rabun said, but "I felt it was the only thing that could take away the pain and nausea."

The procedure was pioneered in 1977, but only a handful of facilities have the required technology. MUSC became the first center in the state to offer the treatment.

Dr. Katherine Morgan, the surgeon who performed Rabun's procedure, said about 40 percent of patients who have the treatment do not require insulin. The others may still need insulin but find their diabetes much easier to control, she said. Surgical risks include bleeding and blood clots.

It will be a few more weeks before the success of Rabun's transplant is clear, but Morgan said she's already starting to taper down on insulin, a sign that the islets are working. Without her pancreas, Rabun will need to take a supplement to help her digest fatty foods.

The National Cancer Institute recognized the Hollings Cancer Center this month as a leader in research. "Part of the NCI designation is to increase novel therapies for cancer patients," Cole said.

To that end, the clean lab will be used to research cancer vaccines. Specifically, scientists are interested in dendritic cells, a subset of white blood cells that can activate the immune system to recognize certain cancers, including pancreas, lung and breast cancers.

A breast cancer trial not yet underway will focus on HER-2, a protein that promotes cancer cells.

"We're going to load these dendritic cells with pieces of HER-2," Nishimura said. "The goal is for the dendritic cells to activate the immune system to recognize HER-2, so that they can attack the tumor cells which express HER-2."

Reach Jill Coley at 937-5719 or jcoley@postandcourier.com.