Autologous Islet Transplantation in Patients Requiring Pancreatectomy

A Broader Spectrum of Indications Beyond Chronic Pancreatitis

Research output: Contribution to journalArticle

Abstract

Islet autotransplantation (IAT) is usually performed in patients undergoing pancreatic surgery for chronic pancreatitis. In the present series, IAT was offered also to patients undergoing pancreatic surgery for both nonmalignant and malignant diseases, having either completion pancreatectomy as treatment for severe pancreatic fistulas (n = 21) or extensive distal pancreatectomy for neoplasms of the pancreatic neck (n = 19) or pancreatoduodenectomy because of the high risk of pancreatic fistula (n = 32). Fifty-eight of 72 patients who were eligible to this broader spectrum of indication actually received IAT. There was no evidence of a higher-than-expected rate of major complications for pancreatectomy. Forty-five patients receiving IAT were still alive at the time of the last scheduled follow-up (1375 ± 365 days). Eighteen (95%) of 19 and 11 (28%) of 39 patients reached insulin independence after partial or total pancreatectomy, respectively. The metabolic results were dependent on the transplanted islet mass. Thirty-one of 58 patients had malignant diseases of the pancreas or periampullary region, and only three patients developed ex novo liver metastases after IAT (median follow-up 914 ± 382 days). Our data demonstrate the feasibility, efficacy, and safety of IAT for a broader spectrum of clinical indications beyond chronic pancreatitis.

Original languageEnglish
Pages (from-to)1812-1826
Number of pages15
JournalAmerican Journal of Transplantation
Volume16
Issue number6
DOIs
Publication statusPublished - 2016

Fingerprint

Islets of Langerhans Transplantation
Pancreatectomy
Autologous Transplantation
Chronic Pancreatitis
Pancreatic Fistula
Pancreaticoduodenectomy
Head and Neck Neoplasms
Pancreatic Neoplasms
Pancreas
Insulin
Neoplasm Metastasis
Safety
Liver

ASJC Scopus subject areas

  • Immunology and Allergy
  • Medicine(all)
  • Pharmacology (medical)
  • Transplantation

Cite this

@article{2a00bb9f5e4f48329d6f7a3ac04bc10d,
title = "Autologous Islet Transplantation in Patients Requiring Pancreatectomy: A Broader Spectrum of Indications Beyond Chronic Pancreatitis",
abstract = "Islet autotransplantation (IAT) is usually performed in patients undergoing pancreatic surgery for chronic pancreatitis. In the present series, IAT was offered also to patients undergoing pancreatic surgery for both nonmalignant and malignant diseases, having either completion pancreatectomy as treatment for severe pancreatic fistulas (n = 21) or extensive distal pancreatectomy for neoplasms of the pancreatic neck (n = 19) or pancreatoduodenectomy because of the high risk of pancreatic fistula (n = 32). Fifty-eight of 72 patients who were eligible to this broader spectrum of indication actually received IAT. There was no evidence of a higher-than-expected rate of major complications for pancreatectomy. Forty-five patients receiving IAT were still alive at the time of the last scheduled follow-up (1375 ± 365 days). Eighteen (95{\%}) of 19 and 11 (28{\%}) of 39 patients reached insulin independence after partial or total pancreatectomy, respectively. The metabolic results were dependent on the transplanted islet mass. Thirty-one of 58 patients had malignant diseases of the pancreas or periampullary region, and only three patients developed ex novo liver metastases after IAT (median follow-up 914 ± 382 days). Our data demonstrate the feasibility, efficacy, and safety of IAT for a broader spectrum of clinical indications beyond chronic pancreatitis.",
author = "Gianpaolo Balzano and Paola Maffi and Rita Nano and Alessia Mercalli and R. Melzi and Francesca Aleotti and Alessandro Zerbi and {De Cobelli}, Francesco and Francesca Gavazzi and P. Magistretti and Marina Scavini and Jacopo Peccatori and Antonio Secchi and Fabio Ciceri and {Del Maschio}, Alessandro and Massimo Falconi and Lorenzo Piemonti",
year = "2016",
doi = "10.1111/ajt.13656",
language = "English",
volume = "16",
pages = "1812--1826",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Autologous Islet Transplantation in Patients Requiring Pancreatectomy

T2 - A Broader Spectrum of Indications Beyond Chronic Pancreatitis

AU - Balzano, Gianpaolo

AU - Maffi, Paola

AU - Nano, Rita

AU - Mercalli, Alessia

AU - Melzi, R.

AU - Aleotti, Francesca

AU - Zerbi, Alessandro

AU - De Cobelli, Francesco

AU - Gavazzi, Francesca

AU - Magistretti, P.

AU - Scavini, Marina

AU - Peccatori, Jacopo

AU - Secchi, Antonio

AU - Ciceri, Fabio

AU - Del Maschio, Alessandro

AU - Falconi, Massimo

AU - Piemonti, Lorenzo

PY - 2016

Y1 - 2016

N2 - Islet autotransplantation (IAT) is usually performed in patients undergoing pancreatic surgery for chronic pancreatitis. In the present series, IAT was offered also to patients undergoing pancreatic surgery for both nonmalignant and malignant diseases, having either completion pancreatectomy as treatment for severe pancreatic fistulas (n = 21) or extensive distal pancreatectomy for neoplasms of the pancreatic neck (n = 19) or pancreatoduodenectomy because of the high risk of pancreatic fistula (n = 32). Fifty-eight of 72 patients who were eligible to this broader spectrum of indication actually received IAT. There was no evidence of a higher-than-expected rate of major complications for pancreatectomy. Forty-five patients receiving IAT were still alive at the time of the last scheduled follow-up (1375 ± 365 days). Eighteen (95%) of 19 and 11 (28%) of 39 patients reached insulin independence after partial or total pancreatectomy, respectively. The metabolic results were dependent on the transplanted islet mass. Thirty-one of 58 patients had malignant diseases of the pancreas or periampullary region, and only three patients developed ex novo liver metastases after IAT (median follow-up 914 ± 382 days). Our data demonstrate the feasibility, efficacy, and safety of IAT for a broader spectrum of clinical indications beyond chronic pancreatitis.

AB - Islet autotransplantation (IAT) is usually performed in patients undergoing pancreatic surgery for chronic pancreatitis. In the present series, IAT was offered also to patients undergoing pancreatic surgery for both nonmalignant and malignant diseases, having either completion pancreatectomy as treatment for severe pancreatic fistulas (n = 21) or extensive distal pancreatectomy for neoplasms of the pancreatic neck (n = 19) or pancreatoduodenectomy because of the high risk of pancreatic fistula (n = 32). Fifty-eight of 72 patients who were eligible to this broader spectrum of indication actually received IAT. There was no evidence of a higher-than-expected rate of major complications for pancreatectomy. Forty-five patients receiving IAT were still alive at the time of the last scheduled follow-up (1375 ± 365 days). Eighteen (95%) of 19 and 11 (28%) of 39 patients reached insulin independence after partial or total pancreatectomy, respectively. The metabolic results were dependent on the transplanted islet mass. Thirty-one of 58 patients had malignant diseases of the pancreas or periampullary region, and only three patients developed ex novo liver metastases after IAT (median follow-up 914 ± 382 days). Our data demonstrate the feasibility, efficacy, and safety of IAT for a broader spectrum of clinical indications beyond chronic pancreatitis.

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