title: Autologous Islet Transplantation in Patients Requiring Pancreatectomy: A Broader Spectrum of Indications Beyond Chronic Pancreatitis.
abstract: Islet autotransplantation (IAT) is usually performed in patients undergoing pancreatic surgery for chronic pancreatitis. In the present series, IAT was offered also to patients undergoing pancreatic surgery for both nonmalignant and malignant diseases, having either completion pancreatectomy as treatment for severe pancreatic fistulas (n = 21) or extensive distal pancreatectomy for neoplasms of the pancreatic neck (n = 19) or pancreatoduodenectomy because of the high risk of pancreatic fistula (n = 32). Fifty-eight of 72 patients who were eligible to this broader spectrum of indication actually received IAT. There was no evidence of a higher-than-expected rate of major complications for pancreatectomy. Forty-five patients receiving IAT were still alive at the time of the last scheduled follow-up (1375 ± 365 days). Eighteen (95%) of 19 and 11 (28%) of 39 patients reached insulin independence after partial or total pancreatectomy, respectively. The metabolic results were dependent on the transplanted islet mass. Thirty-one of 58 patients had malignant diseases of the pancreas or periampullary region, and only three patients developed ex novo liver metastases after IAT (median follow-up 914 ± 382 days). Our data demonstrate the feasibility, efficacy, and safety of IAT for a broader spectrum of clinical indications beyond chronic pancreatitis.
authors.affiliation: Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Balzano
authors.affiliation: Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Maffi
authors.affiliation: Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Nano
authors.affiliation: Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mercalli
authors.affiliation: Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Melzi
authors.affiliation: Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Aleotti
authors.affiliation: Pancreatic Surgery Section, Department of General Surgery, IRCCS Istituto Clinico Humanitas, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zerbi
authors.affiliation: Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: De Cobelli
authors.affiliation: Pancreatic Surgery Section, Department of General Surgery, IRCCS Istituto Clinico Humanitas, Milano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Gavazzi
authors.affiliation: Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Magistretti
authors.affiliation: Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Scavini
authors.affiliation: Units of Haematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: J
authors.initials: J
authors.lastname: Peccatori
authors.affiliation: Clinical Transplant Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.|Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Secchi
authors.affiliation: Units of Haematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ciceri
authors.affiliation: Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy.|Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Del Maschio
authors.affiliation: Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.|Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Falconi
authors.affiliation: Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Piemonti
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006085:Graft Survival; D006801:Humans; D016381:Islets of Langerhans Transplantation; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010182:Pancreatic Diseases / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome