The impact of allogenic blood transfusion on the outcomes of total pancreatectomy with islet autotransplantation.
BACKGROUND
Allogenic blood transfusion (ABT) may be needed for severe bleeding during total pancreatectomy with autotransplantation (TPIAT), but may induce inflammation. This study investigated the impact of ABT.


METHODS
With a population of 83 patients who underwent TPIAT from 2006 to 2014, this study compared cytokine levels, patient characteristics, islet characteristics, metabolic outcomes, insulin requirements, and hemoglobin A1c for those who received a blood transfusion (BT) versus no blood transfusion (NBT).


RESULTS
Initially, proinflammatory cytokines were moderately higher in the BT group than the NBT group. Despite longer procedures and more severe bleeding, the BT group had similar values to the NBT group for insulin requirements, serum C-peptide, hemoglobin A1c, and insulin independence rate. The probability of insulin independence was slightly higher in patients receiving ≥3 units of blood.


CONCLUSIONS
ABT induced elevation of proinflammatory cytokines during the perioperative period in TPIAT, but these changes did not significantly change posttransplant islet function.
Islet Cell Laboratory, Baylor Research Institute, 3310 Live Oak Street, Dallas, TX 75204, USA. Electronic address: Gumpei.Yoshimatsu@BSWHealth.org.
Gumpei
G
Yoshimatsu
Department of Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA 22909, USA. Electronic address: rs2vj@virginia.edu.
Rauf
R
Shahbazov
Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Giovanna.Saracino@BSWHealth.org.
Giovanna
G
Saracino
Islet Cell Laboratory, Baylor Research Institute, 3310 Live Oak Street, Dallas, TX 75204, USA. Electronic address: Michael.Lawrence@BSWHealth.org.
Michael C
MC
Lawrence
Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Peter.Kim@BSWHealth.org.
Peter T
PT
Kim
Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Nicholas.Onaca@BSWHealth.org.
Nicholas
N
Onaca
Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Ernest.Beecherl@BSWHealth.org.
Ernest E
EE
Beecherl
Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Bashoo.Naziruddin@BSWHealth.org.
Bashoo
B
Naziruddin
Transplant Division, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Marshall Street, Richmond, VA 23298, USA. Electronic address: marlon.levy@vcuhealth.org.
Marlon F
MF
Levy
D000328:Adult; D001803:Blood Transfusion; D016207:Cytokines / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D016207:Cytokines; D006442:Glycated Hemoglobin; D007328:Insulin
Allogenic blood transfusion; Cytokines; Total pancreatectomy with islet autotransplantation; Transfusion-related immunomodulation