Title: Australian experience with total pancreatectomy with islet autotransplantation to treat chronic pancreatitis
Authors: Bampton, TJ
Holmes-Walker, DJ
Drogemuller, CJ
Radford, T
Anderson, P
Etherton, C
Russell, CH
Khurana, S
Torpy, DJ
Couper, JJ
Couper, RLT
Macintyre, P
Neo, EL
Benitez-Aguirre, P
Thomas, G
Loudovaris, T
Thomas, HE
Palmer, LJ
Wu, DH
Rogers, NM
Williams, L
Hawthorne, WJ
O’Connell, PJ
Kay, TW
Pleass, H
Chen, JW
Coates, PT
Issue Year: 2021
Publisher WILEY
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.
URI: https://publications.svi.edu.au/publications/8205
Other Identifiers 10.1111/ans.16853
Publication type Article