Islet cell transplantation in children

Balamurugan, Appakalai N.; Elder, Deborah A.; Abu‐El‐Haija, Maisam; Nathan, Jaimie D.

doi:10.1016/j.sempedsurg.2020.150925

Cited by 12 publications

(8 citation statements)

References 74 publications

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“…Although surgical techniques for TPIAT may vary from institution to institution, 8,16,17 they generally include removal of the pancreas, spleen, gallbladder, appendix, and duodenum, with or without pylorus resection. Children are more likely to have their pylorus left intact than adults 17 .…”

Section: Overview Of Tpiatmentioning

confidence: 99%

Nutrition support in the pediatric total pancreatectomy with islet autotransplantation recipient

Downs,

Brun,

Bellin

2023

Nut in Clin Prac

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For children with diminished quality of life and chronic pain caused by acute recurrent or chronic pancreatitis who are undergoing total pancreatectomy with islet autotransplantation, postoperative nutrition support has several unique characteristics. Surgical complications may lead to delays in nutrition support initiation or require modifications to the regimen. Early postoperative dysmotility requires the use of temporary enteral nutrition until this improves. The resultant complete exocrine pancreatic insufficiency necessitates lifelong pancreatic enzyme replacement therapy and fat‐soluble vitamin supplementation. A low‐oxalate diet is recommended to prevent kidney stones. Carbohydrate counting is needed for the provision of short‐term insulin dosing and possibly long‐term as well, depending on the transplanted islet yield. Children should have careful nutrition assessment and monitoring at several follow‐up visits during the first year, then annually, and at any time with concerns.

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Section: Overview Of Tpiatmentioning

confidence: 99%

Nutrition support in the pediatric total pancreatectomy with islet autotransplantation recipient

Downs,

Brun,

Bellin

2023

Nut in Clin Prac

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“…Therefore, patients and parents should receive comprehensive counseling and appropriate guidance regarding the potential outcomes and complications of TPAIT. 72 Surgical procedures in children with TPAIT differ from those in adults. The important surgical steps in pediatric patients include special techniques to prevent any inadvertent injury or spasm of the small vessels to the pancreas.…”

Section: Tpiat In Childrenmentioning

confidence: 99%

“…It exposes patients to the long‐term risk of diabetes and its associated complications. Therefore, patients and parents should receive comprehensive counseling and appropriate guidance regarding the potential outcomes and complications of TPAIT 72 …”

Section: Tpiat In Childrenmentioning

confidence: 99%

Current status of total pancreatectomy with islet autotransplantation for chronic and recurrent acute pancreatitis

Yamane,

Anazawa,

Nagai

et al. 2023

Annals of Gastroent Surgery

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Total pancreatectomy with islet autotransplantation (TPIAT) is an established and effective treatment modality for patients diagnosed with intractable chronic pancreatitis (CP) and recurrent acute pancreatitis (RAP). TPIAT primarily aims to manage debilitating pain leading to impaired quality of life among patients with CP or RAP, which can be successfully managed with medical, endoscopic, or surgical interventions. TPIAT is significantly successful in relieving pain associated with CP and improving health‐related quality of life outcomes. Furthermore, the complete loss of pancreatic endocrine function attributed to total pancreatectomy (TP) can be compensated by autologous islet transplantation (IAT). Patients receiving IAT can achieve insulin independence or can be less dependent on exogenous insulin compared with those receiving TP alone. Historically, TPIAT has been mainly used in the United States, and its outcomes have been improving due to technological advancements. Despite some challenges, TPIAT can be a promising treatment for patients with CP‐related intractable pain. Thus far, TPIAT is not commonly performed in Japan. Nevertheless, it may improve health‐related quality of life in Japanese patients with CP, similar to Western patients. This review article aimed to provide an overview of the indications, related procedures, and outcomes of TPIAT and to discuss future prospects in Japan.

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“…Total pancreatectomy offers the advantage of pain relief but leads to diabetes. The risk of diabetes is offset by the islet auto-transplantation intraoperatively, with childrens' glycemic outcomes ranging from insulin-independent to diabetic, with contributing factors such as the timing of surgery from the onset of symptoms, body mass index, pancreas mass, and fibrosis ( 58 ). Pancreatic enzyme replacement therapy is also needed post-operatively as patients have acquired exocrine pancreatic insufficiency.…”

Section: Surgical Managementmentioning

confidence: 99%