Islet Auto Transplantation Following Total Pancreatectomy

Abstract

: Although there is a notable decline in islet function after islet auto transplant, there is still evidence of significant long-term insulin secretion and possible protection against diabetic complications.

Total pancreatectomy with islet cell transplantationvsintrathecal narcotic pump infusion for pain control in chronic pancreatitis

“…Therefore, ICT may probably add some protection against hypoglycemia events and long-term diabetes complications. However, this need to be evaluated independently [20,22] . Female gender, lower body weight and higher number of islet cells transplanted have been suggested to be positive predictive factors of graft survival [8,18,19] .…”

Total Pancreatectomy and Islet Autotransplantation for Chronic Pancreatitis

“…The Leicester series of TP-IAT for CP is the third largest in the literature with more than 50 cases since 1996 (Clayton et al, 2003;Garcea et al, 2009;Webb et al, 2008;Ong et al, 2008). Interestingly, early reports from Leicester did not show a correlation between islet yield and insulin independence (Clayton et al, 2003), in contrast to the Minnesota series (Blondet et al, 2007;Sutherland et al, 2009b;Wahoff et al, 1995a).…”

“…1). The world literature as of 2011 contains reports of about 700 IATs, including the 400 UMN cases cited previously and those done elsewhere (Ahmad et al, 2005;Argo et al, 2008;Clayton et al, 2003;Dixon et al, 2008;Farkas & Pap, 1997;Garcea et al, 2009;Jindal et al, 1998;Oberholzer et al, 2000;Rodriguez et al, 2003;Sarbu et al, 2005;Sutton et al, 2010;Takita et al, 2010;Takita et al, 2011a;Teuscher et al, 1998;Watkins et al, 2003;Webb et al, 2008;White et al, 1998;White et al, 2001;) [2622]. After UMN, the next largest series are at the University of Cincinnati (more than 100) and the University of Leicester (more than 60).…”

“…The largest series published to date on patients undergoing pancreatectomy and IAT have come from the University of Minnesota (Farney et al, 1991;Gores et al, 1992;Gruessner et al, 2004;Jie et al, 2005;Najarian et al, 1979;Najarian et al, 1980;Sutherland et al, 1978;Sutherland et al, 1980a;Sutherland et al, 2004a;Sutherland et al, 2009a;Sutherland et al, 2009b;Sutherland et al, 2011b;Wahoff et al, 1995a) (>400), the University of Cincinnati (Ahmad et al, 2005;Rodriguez et al, 2003;Sutton et al, 2010) (>100), the University of Leicester (Clayton et al, 2003;;Garcea et al, 2009;White SA et al, 1998;White SA et al, 2001;Webb et al, 2008) (>50 cases), but there are many center that are building their series (Argo et al, 2008;Berney T et al, 2000;Desai et al, 2011;Dixon et al, 2008;Jahansouz et al, 2011;Takita et al, 2010;Takita et al, 2011b;Valente et al, 1986) The reports from these centers largely focus on metabolic outcomes, QOL, and pain reduction., but there are many publications on specialized aspects of TP-IAT as have been referenced in this chapter.…”

“…By extrapolation, IAT recipients who are C-peptide-positive, even with an insulin requirement, have a metabolic advantage (Dong et al, 2011). Although only about one-third or less of IAT recipients in the various series are insulin-independent longterm; another third have enough islets to achieve near-normoglycemia with exogenous insulin, usually with one injection daily of the long-acting variety Jie et al, 2005;Sutherland et al, 2009b;Sutherland et al, 2011b), and even those who are on basalbolus insulin regimens are usually C-peptide positive in the modern era (Sutherland et al, 2011b;Webb et al, 2008).…”