title: Positive sterility cultures of transplant solutions during pancreatic islet autotransplantation are associated infrequently with clinical infection.
abstract: BACKGROUND
  Chronic pancreatitis is a painful and often debilitating disease. Total pancreatectomy with intra-portal islet autotransplantation (TP-IAT) is a treatment option that allows for pain relief and preservation of beta-cell mass, thereby minimizing the complication of diabetes mellitus. Cultures of harvested islets are often positive for bacteria, possibly due to frequent procedures prior to TP-IAT, such as endoscopic retrograde cholangiopancreatography (ERCP), stenting, or other operative drainage procedures. It is unclear if these positive cultures contribute to post-operative infections.
  
  
  OBJECTIVE
  We hypothesized that positive cultures of transplant solutions will not be associated with increased infection risk.
  
  
  METHODS
  We reviewed retrospectively the sterility cultures from both the pancreas preservation solution used to transport the pancreas and the final islet preparation for intra-portal infusion of patients who underwent TP-IAT between April 2006 and November 2012. Two hundred fifty-one patients underwent total, near-total, or completion pancreatectomy with IAT and had complete sterility cultures. All patients received prophylactic peri-operative antibiotics. Patients with positive pancreas preservation solution or islet sterility cultures received further antibiotics for 5-7 d. Patients' medical records were reviewed for post-operative infections and causative organisms.
  
  
  RESULTS
  Of the 251 patients included, 151 (61%) had one or more positive bacterial cultures from the pancreas preservation solution or final islet product. Seventy-three of the 251 patients (29%) had an infectious complication. Thirty-four of the 73 (22%) patients with a post-operative infectious complication also had positive cultures. Only seven of 151 patients with positive cultures (4.7%) had an infectious complication caused by the same organism as that isolated from their pancreas or islet cell preparation.
  
  
  CONCLUSIONS
  In autologous islet preparations, isolation solutions frequently have positive cultures, but this finding is associated infrequently with clinical infection.
authors: 1 Department of Surgery, University of Minnesota , Minneapolis, Minnesota.
authors: Kristin P
authors: KP
authors: Colling
authors: Juan J
authors: JJ
authors: Blondet
authors: A N
authors: AN
authors: Balamurugan
authors: Joshua J
authors: JJ
authors: Wilhelm
authors: Ty
authors: T
authors: Dunn
authors: Timothy L
authors: TL
authors: Pruett
authors: David E R
authors: DE
authors: Sutherland
authors: Srinath
authors: S
authors: Chinnakotla
authors: Melena
authors: M
authors: Bellin
authors: Greg J
authors: GJ
authors: Beilman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003470:Culture Media; D005260:Female; D006801:Humans; D007515:Islets of Langerhans / Q000382:microbiology; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D050500:Pancreatitis, Chronic / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D046509:Tissue Culture Techniques; D014182:Transplantation, Autologous / Q000009:adverse effects* / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D003470:Culture Media