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Islet autotransplantation improves glycemic control in patients undergoing elective distal pancreatectomy for benign inflammatory disease
Author(s) -
Siegel Matthew,
Barlowe Trevor,
Smith Kerrington D.,
Chaidarun Sushela S.,
LaBarre Nicolas,
Joseph Elmunzer Badih,
Morgan Katherine A.,
Gardner Timothy B.
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13891
Subject(s) - medicine , autotransplantation , pancreatectomy , glycemic , diabetes mellitus , surgery , retrospective cohort study , insulin , transplantation , resection , endocrinology
Islet autotransplantation (IAT) is increasingly being performed to mitigate against the diabetic complications of pancreatic resection in patients with benign inflammatory pancreatic disorders; however, the glycemic benefit of IAT in patients undergoing partial pancreatic resection is not known. We aimed to determine whether IAT improved glycemic outcomes in patients undergoing distal pancreatectomy for benign inflammatory disease. We performed a multicenter, retrospective case‐control study of patients who underwent distal pancreatic resection with IAT at two U S tertiary care centers. The primary outcome was the mean change in pre‐ vs post‐operative HgA1c following transplant as well as the development of new post‐operative diabetes. Nine patients requiring distal pancreatectomy for benign disease underwent IAT and were compared to 13 historical controls without IAT. Baseline characteristics were similar between groups. With a median follow‐up of 22 months, those who received an IAT had a smaller increase in their pre‐ vs post‐operative HgA1c (0.42 vs 2.83, P = .004), and one case patient (14.3%) vs three control patients (23.1%) developed new post‐operative diabetes ( P = .581). We conclude that patients undergoing distal pancreatic resection for benign inflammatory disease should be considered for IAT, as long‐term glycemic outcomes appear to be improved in those undergoing transplant.