Comparison of Outcomes from Patients with Completion versus Total Pancreatectomy with Islet Autotransplantation: A Single-Institution Experience with 120 Consecutive Cases.
1Islet Cell Laboratory, Baylor Research Institute, Dallas, TX
2Department of Surgery, University of Virginia, Charlottesville, VA
3Transplant Division, VCU Medical Center, Richmond, VA
4Baylor Simmons Transplant Institute, Dallas, TX.
Meeting: 2016 American Transplant Congress
Abstract number: A83
Keywords: Islets, Pancreatitis
Session Information
Session Name: Poster Session A: Clinical Pancreas Transplantation and All Islet Cell Transplantation Topics
Session Type: Poster Session
Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Introduction: Total pancreatectomy (TP) or completion pancreatectomy is considered to effectively eliminate the severe pain from refractory chronic pancreatitis, if prior procedures failed. Islet autotransplantation (IAT) is a treatment option to prevent surgical induced brittle diabetes. The benefits of completion pancreatectomy with IAT in patients with history of prior pancreatic surgery are unclear.
Method; The patients who underwent total or completion pancreatectomy for refractory chronic pancreatitis from 2006 to 2015 at our center were retrospectively analyzed for patient characteristics, islet isolation, and endocrine function after IAT. Patients were divided into the following two groups: prior surgery group with history of Whipple procedure (PD), Peustow procedure or distal pancreatectomy (DP) before TPIAT (PS, n = 15) and the group without any pancreatic surgery (NPS, n = 105).
Results: No significant differences were found in patient characteristics between the two groups. The pancreas weight and islet count after pancreas digestion showed significant difference between two groups (50.2 ± 22.8 and 72.9 ± 26.3 g, p = 0.005 and 295,737 and 412,640 IEQ p = 0.049 between PS and NPS groups respectively). No statistically significant differences between the two groups were observed in post-TPIAT C-peptide and HbA1c. In sub-group analysis, the total islet yield of patients with PD is significantly higher than those with DP (423,625 and 160,594 IEQ in PD and DP; p = 0.02); however, there is no significant difference between Puestow procedure and PD or DP groups. Islet dose DP group were significantly lower in islet dose than both PD and Puestow groups (1,980, 6,266 and 3,949 IE/kg in DP, PD and Puestow groups. p < 0.05 for between DP and either PD or Puestow groups).
Conclusion: No differences were found in islet isolation outcomes as well as post-operative graft function between the PS and NPS groups. Completion pancreatectomy followed by IAT should be a feasible procedure even after the CP patients have prior history of pancreatic surgery.
CITATION INFORMATION: Yoshimatsu G, Takita M, Shahbazov R, Lawrence M, Naziruddin B, Kim P, Levy M, Onaca N. Comparison of Outcomes from Patients with Completion versus Total Pancreatectomy with Islet Autotransplantation: A Single-Institution Experience with 120 Consecutive Cases. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Yoshimatsu G, Takita M, Shahbazov R, Lawrence M, Naziruddin B, Kim P, Levy M, Onaca N. Comparison of Outcomes from Patients with Completion versus Total Pancreatectomy with Islet Autotransplantation: A Single-Institution Experience with 120 Consecutive Cases. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-outcomes-from-patients-with-completion-versus-total-pancreatectomy-with-islet-autotransplantation-a-single-institution-experience-with-120-consecutive-cases/. Accessed May 11, 2025.« Back to 2016 American Transplant Congress