Date: Tuesday, May 2, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 2:42pm-2:54pm
Background: Total pancreatectomy and intra-portal islet cell auto-transplantation (TP/IAT) is increasingly being utilized for the management of chronic pancreatitis (CP), the benefits being removal of the root cause of pain and amelioration of diabetes via islet auto transplantation. However, the long-term durability of this operation remains unclear
Methods: Of the 672 patients that received TP-IAT at our center, 93 patients with 10 years or greater follow up from the recent era (1995-2005) were identified for inclusion in this single-center observational study. End points included narcotic requirements, islet function (Insulin-independence; Partial graft function=C-peptide positive, >0.6ng/dl and No function=C-peptide<0.6mg/dL), and quality of life.
Results: There were 72 patients with complete clinical data at the 5yr and 10 years. The 5-year and 10-year actuarial survival was 88% and 78% respectively. Pancreatitis pain and the severity of pain statistically improved after TP-IAT (p value < 0.001) in 90% of patients. The prevalence of narcotic use declined with time (p=0.001), was12% at 5 years and 11% at 10 years. At 10 years, insulin independence and partial graft function was seen in 17% and 33% respectively. Pediatric patients are more likely to have islet function compared to adults (p=0.013) [Figure 1]. SF-36 QoL assessment demonstrated continued improvements in all tested modules at 10-year follow-up
Conclusions: This represents the first largest series examining long-term outcomes (10 years or more) after TP/IAT. TP/IAT produces durable pain relief and improvement in QOL parameters. Islet auto graft function is sustained even past 10 years.
CITATION INFORMATION: Chinnakotla S, Dunn T, Beilman G, Bellin M, Pruett T, Kirchner V, Wilhelm J, Freeman M, Sutherland D. 10 Years or More of Follow Up After Total Pancreatectomy and Intra Portal Islet Auto Transplantation (TP/IAT) for Treatment of Chronic Pancreatitis, Is It a Durable Operation? Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Chinnakotla S, Dunn T, Beilman G, Bellin M, Pruett T, Kirchner V, Wilhelm J, Freeman M, Sutherland D. 10 Years or More of Follow Up After Total Pancreatectomy and Intra Portal Islet Auto Transplantation (TP/IAT) for Treatment of Chronic Pancreatitis, Is It a Durable Operation? [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/10-years-or-more-of-follow-up-after-total-pancreatectomy-and-intra-portal-islet-auto-transplantation-tpiat-for-treatment-of-chronic-pancreatitis-is-it-a-durable-operation/. Accessed May 21, 2019.
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