Australian experience with total pancreatectomy with islet autotransplantation to treat chronic pancreatitis

Australian Islet Consortium

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: This study aimed to describe the clinical outcomes of total pancreatectomy with islet autotransplantation (TP-IAT) in Australia. Methods: Individuals selected for TP-IAT surgery according to the Minnesota Criteria (Appendix) without evidence of diabetes were evaluated including time to transplantation from pancreatectomy, islet numbers infused and post-transplantation HbA1c, C-peptide, total daily insulin and analgesic requirement. Results: Sixteen individuals underwent TP-IAT from Australia and New Zealand between 2010 and 2020. Two recipients are deceased. The median islet equivalents/kg infused was 4244 (interquartile range (IQR) 2290–7300). The median C-peptide 1 month post-TP-IAT was 384 (IQR 210–579) pmol/L and at median 29.5 (IQR 14.5–46.5) months from transplant was 395 (IQR 139–862) pmol/L. Insulin independence was achieved in eight of 15 (53.3%) surviving recipients. A higher islet equivalents transplanted was most strongly associated with the likelihood of insulin independence (P < 0.05). Of the 15 surviving recipients, 14 demonstrated substantial reduction in analgesic requirement. Conclusion: The TP-IAT programme in Australia has been a successful new therapy for the management of individuals with chronic pancreatitis including hereditary forms refractory to medical treatment to improve pain management with 50% insulin independence rates.

Original languageEnglish (US)
Pages (from-to)2663-2668
Number of pages6
JournalANZ Journal of Surgery
Volume91
Issue number12
DOIs
StatePublished - Dec 2021
Externally publishedYes

Keywords

  • auto-islet transplantation
  • chronic pancreatitis
  • hereditary pancreatitis

ASJC Scopus subject areas

  • Surgery

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