Chronic pancreatitis is a disabling and morbid condition associated with severe pain, and varying degrees of exocrine and endocrine failure. Total pancreatectomy with autoislet cell transplantation (TPIAT) offers an effective strategy for pain relief which limits the metabolic complications associated with brittle diabetes. However, because the islet recovery and isolation facilities developed for allotransplantation are not widely available, TPIAT is limited to select centers. In this report, we demonstrate the feasibility of TPIAT with distant recovery and processing of the islets. Methods: Patients underwent total or near total laparoscopically assisted pancreatic resection. The pancreas was flushed with SPS preservation solution and transferred to the islet isolation facility two hours from the home center. Following islet isolation, purification, and return transport, the islets were infused into the portal vein via repeat laparotomy 8-12 hours later. Results: Seventeen TPIAT procedures have been successfully performed using this protocol over the past 18 months. There have been no mortalities, initial graft losses, or portal venous thromboses. A median of 333,212 Islet Equivalents were infused (range 52,700-854,000). At a median follow up of 164 days (15-524), 29.4% of the patients are insulin free. Among patients with 6 month follow-up data (N=8) the average HbA1c is 6.3 (range 5.1-8.4) and 88% of the patients were c-peptide positive. Patient reported pain scores have improved dramatically. Conclusions: TPIAT with distant islet cell recovery is feasible and appears efficacious based on preliminary outcomes. This program offers the opportunity to expand access to this procedure beyond centers with alloislet isolation facilities.