title: Total pancreatectomy with islet autotransplantation: summary of an NIDDK 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. 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, GI complications in this population, and unique features of children with chronic pancreatitis considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of chronic pancreatitis and total pancreatectomy outcomes and postsurgical diabetes outcomes was repeatedly emphasized.
authors.affiliation: *Departments of Pediatrics and Surgery, University of Minnesota Medical School, Minneapolis, MN †Department of Medicine, Pritzker School of Medicine, Center for Endoscopic Research and Therapeutics (CERT), Chicago, IL ‡Division of Diabetes, Endocrinology, and Metabolism and Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD §Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA ¶Department of Surgery, Medical University of South Carolina, Charleston, SC ‖Baylor Simmons Transplant Institute, Dallas, TX **Department of Surgery, University of Texas Medical Branch, Galveston, TX; and ††Department of Medicine, University of Pennsylvania Perelman School of Medicine, 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: D035843:Biomedical Research; D059350:Chronic Pain / Q000209:etiology / Q000601:surgery; D017408:Guidelines as Topic; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000379:methods; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods; D050500:Pancreatitis, Chronic / Q000150:complications / Q000601:surgery*; D018579:Patient Selection; D012042:Registries; D013997:Time Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration