Session Name: Pancreas and Islet: All Topics
Session Date & Time: None. Available on demand.
*Purpose: Total pancreatectomy with islet auto-transplantation (TPIAT) is becoming the standard of care for patients with chronic pancreatitis, as it provides pain relief and improved quality of life without the loss of glycemic control associated with total pancreatectomy alone. Despite these clear benefits and the high prevalence of chronic pancreatitis in the African American population, this procedure continues to be performed at significantly lower rates compared to the Caucasian population. In this study, we have performed a comparative analysis of the outcomes of the TPIAT procedure between African American and Caucasian patients. We hypothesize that no statistically significant differences in outcomes between these two groups indicates that the comparatively lower rate of TPIAT procedures seen in the African American population is rooted in a lack of access to high-quality healthcare and other social determinants, not worse outcomes.
*Methods: A total of 84 Caucasian and 15 African American patients who had undergone TPIAT were included. Wilcoxon Rank tests were used to compare the HgbA1C, C-peptide, SUITO index, subjective pain score, and narcotic dose between these two groups at the pre-operative as well as 6-month and 12-month post-operative time periods.
*Results: There were no significant differences in any of the surgical outcome measures between the two groups at either 6-month or 1-year post-operative. There were no significant differences in age at transplant or islet yield. Both Caucasian and African American patients experienced a decrease in pain score and narcotic dose at 6 months as well as an increase in basal glucose and HgBA1c.
*Conclusions: These results indicate that African American patients have comparable outcomes to their Caucasian counterparts, suggesting that the disparity in the rate of TPIAT procedures performed in these two groups is contributable to social determinants such access to quality health care and the perception of physicians that African American patients can be expected to have worse outcomes comparatively. Based on these findings, we propose that physicians evaluating patients for TPIAT candidacy not use African American race as an indicator for expected surgical outcome.
To cite this abstract in AMA style:Kanak MA, Spriggs JB, Coughenour P, Kalivarathan J, Saravanan P, Levy MF. Comparative Outcomes of TPIAT in African American and Caucasian Patients with Chronic Pancreatitis [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/comparative-outcomes-of-tpiat-in-african-american-and-caucasian-patients-with-chronic-pancreatitis/. Accessed September 23, 2021.
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