Salvage Islet Auto Transplantation After Relaparatomy. Issue 10 (October 2017)
- Record Type:
- Journal Article
- Title:
- Salvage Islet Auto Transplantation After Relaparatomy. Issue 10 (October 2017)
- Main Title:
- Salvage Islet Auto Transplantation After Relaparatomy
- Authors:
- Balzano, Gianpaolo
Nano, Rita
Maffi, Paola
Mercalli, Alessia
Melzi, Raffaelli
Aleotti, Francesca
Gavazzi, Francesca
Berra, Cesare
De Cobelli, Francesco
Venturini, Massimo
Magistretti, Paola
Scavini, Marina
Capretti, Giovanni
Del Maschio, Alessandro
Secchi, Antonio
Zerbi, Alessandro
Falconi, Massimo
Piemonti, Lorenzo - Abstract:
- Abstract : Background: To assess feasibility, safety, and metabolic outcome of islet auto transplantation (IAT) in patients undergoing completion pancreatectomy because of sepsis or bleeding after pancreatic surgery. Methods: From November 2008 to October 2016, approximately 22 patients were candidates to salvage IAT during emergency relaparotomy because of postpancreatectomy sepsis (n = 11) or bleeding (n = 11). Feasibility, efficacy, and safety of salvage IAT were compared with those documented in a cohort of 36 patients who were candidate to simultaneous IAT during nonemergency preemptive completion pancreatectomy through the pancreaticoduodenectomy. Results: The percentage of candidates that received the infusion of islets was significantly lower in salvage IAT than simultaneous IAT (59.1% vs 88.9%, P = 0.008), mainly because of a higher rate of inadequate islet preparations. Even if microbial contamination of islet preparation was significantly higher in candidates to salvage IAT than in those to simultaneous IAT (78.9% vs 20%, P < 0.001), there was no evidence of a higher rate of complications related to the procedure. Median follow-up was 5.45 ± 0.52 years. Four (36%) of 11 patients reached insulin independence, 6 patients (56%) had partial graft function, and 1 patient (9%) had primary graft nonfunction. At the last follow-up visit, median fasting C-peptide was 0.43 (0.19-0.93) ng/mL; median insulin requirement was 0.38 (0.04-0.5) U/kg per day, and median HbA1c wasAbstract : Background: To assess feasibility, safety, and metabolic outcome of islet auto transplantation (IAT) in patients undergoing completion pancreatectomy because of sepsis or bleeding after pancreatic surgery. Methods: From November 2008 to October 2016, approximately 22 patients were candidates to salvage IAT during emergency relaparotomy because of postpancreatectomy sepsis (n = 11) or bleeding (n = 11). Feasibility, efficacy, and safety of salvage IAT were compared with those documented in a cohort of 36 patients who were candidate to simultaneous IAT during nonemergency preemptive completion pancreatectomy through the pancreaticoduodenectomy. Results: The percentage of candidates that received the infusion of islets was significantly lower in salvage IAT than simultaneous IAT (59.1% vs 88.9%, P = 0.008), mainly because of a higher rate of inadequate islet preparations. Even if microbial contamination of islet preparation was significantly higher in candidates to salvage IAT than in those to simultaneous IAT (78.9% vs 20%, P < 0.001), there was no evidence of a higher rate of complications related to the procedure. Median follow-up was 5.45 ± 0.52 years. Four (36%) of 11 patients reached insulin independence, 6 patients (56%) had partial graft function, and 1 patient (9%) had primary graft nonfunction. At the last follow-up visit, median fasting C-peptide was 0.43 (0.19-0.93) ng/mL; median insulin requirement was 0.38 (0.04-0.5) U/kg per day, and median HbA1c was 6.6% (5.9%-8.1%). Overall mortality, in-hospital mortality, metabolic outcome, graft survival, and insulin-free survival after salvage IAT were not different from those documented after simultaneous IAT. Conclusions: Our data demonstrate the feasibility, efficacy, and safety of salvage IAT after relaparotomy. Abstract : This cohort study demonstrates that salvage islet autotransplantation in patients undergoing emergency complete pancreatectomy is feasible, effective, safe, and comparable to that observed after elective simultaneous islet autotransplantation. Supplemental digital content is available in the text. … (more)
- Is Part Of:
- Transplantation. Volume 101:Issue 10(2017)
- Journal:
- Transplantation
- Issue:
- Volume 101:Issue 10(2017)
- Issue Display:
- Volume 101, Issue 10 (2017)
- Year:
- 2017
- Volume:
- 101
- Issue:
- 10
- Issue Sort Value:
- 2017-0101-0010-0000
- Page Start:
- Page End:
- Publication Date:
- 2017-10
- Subjects:
- Transplantation of organs, tissues, etc -- Periodicals
Transplantation immunology -- Periodicals
617.95 - Journal URLs:
- http://journals.lww.com/pages/default.aspx ↗
- DOI:
- 10.1097/TP.0000000000001750 ↗
- Languages:
- English
- ISSNs:
- 0041-1337
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 9024.990000
British Library DSC - BLDSS-3PM
British Library STI - ELD Digital store - Ingest File:
- 8294.xml