Use of hyperglycemic clamp to assess pancreatectomy and islet cell autotransplant in patient with heterotaxy syndrome and dorsal pancreas agenesis leading to chronic pancreatitis

Abstract

Chronic pancreatitis is a progressive inflammatory condition, with pain as the most frequent and dominant symptom. 1 Treatment of chronic pain related to chronic pancreatitis is based on a step-up approach, starting with conservative measures and endoscopic procedures. 2 However, in a small segment of chronic pancreatitis patients, these therapies are not feasible or are unsuccessful. These patients are in general highly dependent on opioid analgesics and their quality of life is severely impaired. Total pancreatectomy

Dorsal Pancreas Agenesis in an Organ Donor: To Accept or to Discard for Transplantation?

“…In addition, 2 successful cases of islet transplantation (1 allotransplantation and 1 autotransplantation) from patients with DPA have been described. 19 , 20 One was a type 1 diabetes patient who received islet cells from a single deceased donor with a partial DPA. The total islet mass transplanted was 422 × 10 3 islet equivalents with a viability of 85%.…”

“… 19 We recently reported a successful case of islet autotransplantation following total pancreatectomy in a patient with DPA who suffered from intractable abdominal pain due to episodes of pancreatitis. 20 Before the procedure, the number of β cells and their functional capacity had been estimated by a hyperglycemic clamp test and were deemed sufficient. The pancreas weighted 66 g (body weight: 48 kg) and a total of 226 × 10 3 islet equivalents were isolated, of which 4.7 × 10 3 islet equivalents per kilogram were injected intraportally.…”