title: Six-Year Graft Survival After Partial Pancreas Heterotopic Auto-Transplantation: A Case Report.
abstract: BACKGROUND
  Long-term graft survival of partial pancreas auto-transplantation after total pancreatectomy has not been clarified. The clinical implications of repeat completion pancreatectomy for locally recurrent pancreatic carcinoma in the remnant pancreas after initial pancreatectomy also have not been clarified.
  
  
  METHODS
  We have previously reported a 61-year-old woman presenting with re-sectable carcinoma of the remnant pancreas at 3 years after undergoing a pylorus-preserving pancreaticoduodenectomy for invasive ductal carcinoma of the pancreas head. We also performed distal pancreas auto-transplantation with the use of a part of the resected pancreas to preserve endocrine function.
  
  
  RESULTS
  The patient was discharged at 20 days after surgery without any complications. She had been followed regularly in our outpatient clinic. She had been treated with S-1 as adjuvant chemotherapy; 72 months after the completion total pancreatectomy with distal partial pancreas auto-transplantation, the patient was alive without any evidence of the pancreatic carcinoma recurrence. The pancreas graft was still functioning with a blood glucose level of 112 mg/dL, HbA1C of 6.7%, and serum C-peptide of 1.2 ng/mL; and urinary C-peptide was 11.6 μg/d.
  
  
  CONCLUSIONS
  Our patient demonstrated that repeated pancreatectomies can provide a chance for survival after a locally recurrent pancreatic carcinoma if the disease is limited to the remnant pancreas. An additional partial pancreas auto-transplantation was successfully performed to preserve endocrine function. However, the indications for pancreas auto-transplantation should be decided carefully in the context of pancreatic carcinoma recurrence.
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan. Electronic address: kobataka@med.niigata-u.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Miura
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ishikawa
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Soma
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: Z
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yuza
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hirose
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takizawa
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nagahashi
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Sakata
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kameyama
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: S-I
authors.initials: SI
authors.lastname: Kosugi
authors.affiliation: Department of Surgery, Tachikawa General Hospital, Nagaoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tada
authors.affiliation: Department of Surgery, Tachikawa General Hospital, Nagaoka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Hirukawa
authors.affiliation: Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Wakai
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008875:Middle Aged; D016035:Pancreas Transplantation; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016042:Transplantation, Heterotopic