title: Total pancreatectomy with islet autotransplantation: summary of a National Institute of Diabetes and Digestive and Kidney diseases workshop.
abstract: A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases focused on research gaps and opportunities in total pancreatectomy with islet autotransplantation (TPIAT) for the management of chronic pancreatitis (CP). The session was held on July 23, 2014, and structured into 5 sessions: (1) patient selection, indications, and timing; (2) technical aspects of TPIAT; (3) improving success of islet autotransplantation; (4) improving outcomes after total pancreatectomy; and (5) registry considerations for TPIAT. The current state of knowledge was reviewed; knowledge gaps and research needs were specifically highlighted. Common themes included the need to identify which patients best benefit from and when to intervene with TPIAT, current limitations of the surgical procedure, diabetes remission and the potential for improvement, opportunities to better address pain remission, gastrointestinal complications in this population, and unique features of children with CP considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of CP and total pancreatectomy outcomes as well as postsurgical diabetes outcomes was repeatedly emphasized.
authors.affiliation: From the *Departments of Pediatrics and Surgery, University of Minnesota Medical School, Minneapolis, MN; †The Department of Medicine, Pritzker School of Medicine, Center for Endoscopic Research and Therapeutics, University of Chicago, Chicago, IL; ‡The Divisions of Diabetes, Endocrinology and Metabolism and of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD; §The Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA; ∥The Department of Surgery, Medical University of South Carolina, Charleston, SC; ¶Baylor Simmons Transplant Institute, Dallas, TX; #The Department of Surgery, University of Texas Medical Branch, Galveston, TX; and **The Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Melena D
authors.initials: MD
authors.lastname: Bellin
authors.forename: Andres
authors.initials: A
authors.lastname: Gelrud
authors.forename: Guillermo
authors.initials: G
authors.lastname: Arreaza-Rubin
authors.forename: Ty B
authors.initials: TB
authors.lastname: Dunn
authors.forename: Abhinav
authors.initials: A
authors.lastname: Humar
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Morgan
authors.forename: Bashoo
authors.initials: B
authors.lastname: Naziruddin
authors.forename: Cristiana
authors.initials: C
authors.lastname: Rastellini
authors.forename: Michael R
authors.initials: MR
authors.lastname: Rickels
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Schwarzenberg
authors.forename: Dana K
authors.initials: DK
authors.lastname: Andersen
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D000068800:Etanercept; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation / Q000191:economics / Q000379:methods* / Q000592:standards; D054586:National Institute of Diabetes and Digestive and Kidney Diseases (U.S.); D010180:Pancreatectomy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D050500:Pancreatitis, Chronic / Q000188:drug therapy / Q000235:genetics / Q000601:surgery*; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D058996:Quality Improvement; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012042:Registries; D012106:Research; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D007328:Insulin; D018124:Receptors, Tumor Necrosis Factor; D006493:Heparin; D000068800:Etanercept