Institutional indications for islet transplantation after total pancreatectomy

Naoaki Sakata, Shinichi Egawa, Fuyuhiko Motoi, Yukio Mikami, Masaharu Ishida, Takeshi Aoki, Shigeru Ottomo, Shoji Fukuyama, Toshiki Rikiyama, Yu Katayose, Masafumi Goto, Michiaki Unno

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Background/Purpose: This study was designed to establish institutional indications for pancreatic islet transplantation by examining patients with total pancreatectomy as candidates for islet allotransplantation. Methods: In 12 patients who underwent total pancreatectomy, we compared pre-and postoperative plasma glucose level, body mass index, HbA1c, and daily insulin use; we examined candidacy for islet allotransplantation based on the guidelines of Japan's islet transplantation registry. Results: Eight of the 12 patients with total pancreatectomy were operated for intraductal papillary mucinous neoplasm. At our institution, the 5-year survival of patients with intraductal papillary mucinous neoplasm was far better (76.3%) than that of patients with pancreatic cancer. Postoperatively, plasma glucose level, HbA1c, and daily insulin use were increased in all patients with total pancreatectomy. Of the 12 patients treated with total pancreatectomy, 4 (intraductal papillary mucinous neoplasm, n = 2; islet cell tumor, n = 1; and acute pancreatitis due to arteriovenous malformation, n = 1) showed deteriorated diabetic control and therefore were considered to be candidates for islet allotransplantation according to the guidelines. Conclusions: Islet allotransplantation could be indicated for patients with favorable postoperative survival who have had a total pancreatectomy for either benign or neoplastic disease.

Original languageEnglish
Pages (from-to)488-492
Number of pages5
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Volume15
Issue number5
DOIs
Publication statusPublished - 2008 Oct 15

Keywords

  • Acute pancreatitis
  • Arteriovenous malformation
  • Intraductal papillary mucinous neoplasm (IPMN)
  • Islet transplantation
  • Total pancreatectomy

ASJC Scopus subject areas

  • Surgery
  • Hepatology

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