Effect of the Duration of Chronic Pancreatitis on Pancreas Islet Yield and Metabolic Outcome Following Islet Autotransplantation.
BACKGROUND
Total pancreatectomy (TP) with islet autotransplantation (IAT) is a highly selected treatment for severe pain associated with chronic pancreatitis (CP) after exhausting medical and endoscopic therapies. The effect of duration of CP on TP-IAT has not been clarified.


METHODS
Retrospective review of a consecutive cohort undergoing TP-IAT was performed. Patients were classified according to islet dose of <2500 IEQ/kg, 2500 to 5000 IEQ/kg, and >5000 IEQ/kg. Islet yield and metabolic outcomes were compared to disease duration of CP.


RESULTS
A total of 76 CP patients underwent TP-IAT. Longer disease duration was associated with lower islet yield transplanted (Spearman's correlation = -0.24; p = 0.04) for total cohort. Highest absolute value of the coefficient was found in patients with hereditary CP when study subjects were classified by the etiology of CP (correlation = -0.72; p = 0.02). Higher islet yields were significantly associated with better metabolic outcomes (7.6 ± 1.1 vs 6.6 ± 1.1% of HbA1c post-TPIAT in patients with <2500 and >5000 IEQ/kg transplanted, respectively; p = 0.04).


CONCLUSIONS
The duration of CP could affect islet yield and metabolic outcomes. The time since the diagnosis of CP should be considered when selecting patients for islet autotransplantation.
Islet Cell Laboratory, Islet Cell Laboratory, Baylor Research Institute, 3410 Worth St. #950, Dallas, TX, 75246, USA, morihito.takita@baylorhealth.edu.
Morihito
M
Takita
Luis F
LF
Lara
Bashoo
B
Naziruddin
Rauf
R
Shahbazov
Michael C
MC
Lawrence
Peter T
PT
Kim
Nicholas
N
Onaca
James S
JS
Burdick
Marlon F
MF
Levy
D000328:Adult; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007515:Islets of Langerhans / Q000378:metabolism*; D016381:Islets of Langerhans Transplantation; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D050500:Pancreatitis, Chronic / Q000209:etiology / Q000601:surgery*; D018579:Patient Selection; D012189:Retrospective Studies; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human