title: Diabetes-free survival in patients who underwent islet autotransplantation after 50% to 60% distal partial pancreatectomy for benign pancreatic tumors.
abstract: BACKGROUND
  Several retrospective studies with short-term follow-up have demonstrated a low rate of new-onset diabetes after distal pancreatectomy for benign pancreatic tumors. We sought to determine the long-term diabetes-free survival of patients who underwent islet autotransplantation (IAT) after distal pancreatectomy and to identify any associations between the isolation parameters of autologous islets and diabetes-free survival.
  
  
  METHODS
  Among the 37 nondiabetic patients who underwent 50% to 60% partial pancreatectomy, 20 underwent IAT (IAT group; median follow-up period, 61 months). In the IAT group, diabetes-free survival was determined based on annual oral glucose tolerance tests, fasting blood glucose, and hemoglobin A1C.
  
  
  RESULTS
  The 7-year diabetes-free survival rate was 51% in the IAT group (median follow-up period, 61 months) and 45% in the 37 study subjects. Diabetes-free survival was significantly prolonged when islet yield per gram of pancreas weight was more than 5154 islet equivalents (IEQ)/g, even in patients with prediabetes and high insulin resistance who had a markedly high rate of diabetes development. The proportion of patients with impaired glucose tolerance at 2 years after distal pancreatectomy was 12 of 16 in the control group, 6 of 7 in patients with islet yields of less than 5154 IEQ/g, and 3 of 11 in patients with islet yields of more than 5154 IEQ/g (P=0.019).
  
  
  CONCLUSIONS
  Partial (50%-60%) pancreatectomy for benign pancreatic tumors had a major metabolic consequence, especially in patients with prediabetes and high insulin resistance. In this setting, prolonged diabetes-free survival was observed in patients who underwent IAT when a high islet yield per gram of pancreas was achieved.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sang-Man
authors.initials: SM
authors.lastname: Jin
authors.forename: Seung-Hoon
authors.initials: SH
authors.lastname: Oh
authors.forename: Soo Kyoung
authors.initials: SK
authors.lastname: Kim
authors.forename: Hye Seung
authors.initials: HS
authors.lastname: Jung
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Kee-Taek
authors.initials: KT
authors.lastname: Jang
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Jae Hyeon
authors.initials: JH
authors.lastname: Kim
authors.forename: Myung-Shik
authors.initials: MS
authors.lastname: Lee
authors.forename: Moon-Kyu
authors.initials: MK
authors.lastname: Lee
authors.forename: Kwang-Won
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance / Q000502:physiology; D016381:Islets of Langerhans Transplantation / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000601:surgery*; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D011236:Prediabetic State / Q000503:physiopathology; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome