Risk Factors for Early Readmission After Total Pancreatectomy with Islet Auto Transplantation.
1Charles O.Strikler Transplant Center, Department of Surgery, University of Virginia, Charlottesville, VA
2Baylor Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX
3Transplant Division, Virginia Commonwealth University, Richmond, VA.
Meeting: 2016 American Transplant Congress
Abstract number: A82
Keywords: Islets, Pancreas, Post-operative complications, Risk factors
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: Readmission after Total Pancreatectomy with Islet Auto Transplantation (TPIAT) is common, but no data is available on reasons for readmission and islet graft function.
Aims: To evaluate the rate of readmission to hospital following TPIAT.
Materials and Methods: A total of 83 consecutive patients, who underwent TPIAT at a single transplant center between 2006 and 2015 were included in the study. Patient and transplant characterists data, such as reasons for readmissions and islet function, were collected at 1, 3, 6 and 12 months post-transplant and stored in an institutional prospectively maintained database. The primary outcome was unplanned 30-day readmission to the hospital.Multivariate methods were used to analyze the association of potential risk factors for readmission and graft function.
Results: Among 83 patients who underwent TPIAT during the study period, twenty-one patients (25%) were readmitted within 30 days post TPIAT. Gastrointestinal problems (52.4%) and surgical infection (42.8%) were the most common reasons for readmission. One patient (4.8%) was readmitted because of a vascular problem. Multivariable logistic regression revealed that the Pylorus preservation group was 9 times more likely to be readmitted than the antrumectomy group (Odds Ratio (OR), 9.23; 95% Confidence Interval (CI), and 2.07-30.3). The delayed gastric emptying (DGE) group had 3 times the likelihood of being readmitted within 30 days (OR, 3.05; 95% CI, 1.06-11.01) compared with patients with no DGE. Readmission and non-readmission groups had similar serum C-peptide and HbA1c levels at across all postoperative time periods. However, daily insulin requirements were significantly higher for the non-readmitted patients compared to the readmitted patients (p=0.025). Additionally, graft survival curves of readmitted and non-readmitted patients were not statistically different.
Conclusion: In total, 25 % of patients required early readmission after TPIAT. Pylorus preservation surgery, DGE were major patient related factors that were associated with the increased risk of readmission. Auto islet graft function is not impaired during the follow up period among patients with early readmission.
CITATION INFORMATION: Shahbazov R, Bashoo N, Yoshimatsu G, Saracino G, Azari F, Onaca N, Kim P, Levy M. Risk Factors for Early Readmission After Total Pancreatectomy with Islet Auto Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Shahbazov R, Bashoo N, Yoshimatsu G, Saracino G, Azari F, Onaca N, Kim P, Levy M. Risk Factors for Early Readmission After Total Pancreatectomy with Islet Auto Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/risk-factors-for-early-readmission-after-total-pancreatectomy-with-islet-auto-transplantation/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress