title: Islet Cell Yield Following Remote Total Pancreatectomy With Islet Autotransplant is Independent of Cold Ischemia Time.
abstract: Total pancreatectomy with islet autotransplantation is increasingly being performed remotely, that is, removing the pancreas in 1 location, isolating the islet cells in another location, then returning the islets to the original location for reimplantation into the patient. We determined the influence of extended cold ischemia time on key clinical outcomes in remote islet autotransplantation.
  
  
  
  We evaluated patients who underwent remote islet autotransplantation at 2 centers from 2011 to 2014. Patients were divided into 2 groups: those with and those without a decrease in C-peptide greater than 50% from baseline. The primary clinical outcome was the quantity of isolated islet equivalents per kilogram body weight (IEQs/kg).
  
  
  
  Twenty-five patients met inclusion criteria; 15 had a decrease in C-peptide greater than 50% from baseline and had lower corresponding IEQs/kg compared with those without a decrease greater than 50% (4045 vs 6654 IEQs/kg, P = 0.01). There was no difference in cold ischemia time between the 2 groups (664 vs 600 minutes, P = 0.25). Daily insulin use at 1 year nearly met statistical significance (25.3 vs 8 U, P = 0.06), as did glycated hemoglobin (8.07 vs 6.69 mmol/L, P = 0.06).
  
  
  
  Cold ischemia time does not influence islet yield in patients undergoing pancreatectomy with remote isolation.
authors.affiliation: From the Sections of *Gastroenterology and Hepatology and †General Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH; ‡Section of Gastroenterology and Hepatology, Digestive Disease Institute, §Department of Endocrinology, Endocrinology and Metabolism Institute, and ∥Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH; and Sections of ¶Transplant Surgery and #Endocrinology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Kesseli
authors.forename: Kerrington D
authors.initials: KD
authors.lastname: Smith
authors.forename: Min K
authors.initials: MK
authors.lastname: Jung
authors.forename: Yu K
authors.initials: YK
authors.lastname: Lin
authors.forename: R Matthew
authors.initials: RM
authors.lastname: Walsh
authors.forename: Betul
authors.initials: B
authors.lastname: Hatipoglu
authors.forename: David A
authors.initials: DA
authors.lastname: Axelrod
authors.forename: Sushela S
authors.initials: SS
authors.lastname: Chaidarun
authors.forename: Tyler K
authors.initials: TK
authors.lastname: Stevens
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Gardner
mesh_terms: D000208:Acute Disease; D000328:Adult; D002096:C-Peptide / Q000097:blood; D050377:Cold Ischemia / Q000379:methods*; D005260:Female; D006801:Humans; D007515:Islets of Langerhans / Q000601:surgery*; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010195:Pancreatitis / Q000601:surgery; D050500:Pancreatitis, Chronic / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D002096:C-Peptide