Total Pancreatectomy and Islet Auto-Transplantation for Chronic Painful Pancreatitis: An Overview

Abstract

Chronic pancreatitis is a progressive and irreversible process that can lead to pain, pancreatic dysfunction, and even malignancy. Management can be difficult, with some patients proving refractory to standard medical or endoscopic treatments. These patients generally depend on narcotics to manage their symptoms. Total pancreatectomy and Islet Auto-Transplantation (TP-IAT) can offer relief for such patients by removing the root cause of their pain. The pancreas is entirely resected and islets are isolated then infused back into the patient. The islets are most commonly infused into the liver, where they engraft and begin to function within months. Pain relief is substantial and patients report improved quality of life following the procedure. Approximately one third of patients achieve insulin independence (19-40% of cases, variable by institution). Most of the patients who do go on to require insulin demonstrate some degree of islet function, thus minimizing the severity of their diabetes and associated complications. TP-IAT is an effective treatment for patients with debilitating chronic pancreatitis that can offer pain relief, narcotic independence, and improved quality of life to recipients.

Islet isolation from the pancreas after pancreatectomy. Indications, methodology, evaluation of results

“…Для этого разработана технология выде ления островков Лангерганса (ОЛ) и их введение в виде аутотрансплантации. Ауто трансплантацию ОЛ ПЖ применяют чаще всего при хроническом болевом панкреатите, их вводят преимущественно в воротную вену [1][2][3][4]. При этом исключена аутоиммунная реакция и нет необходимости в иммуносупрессии в посттрансплантационном периоде.…”