Outcomes of total pancreatectomy with islet autotransplantation:A systematic review and meta-analysis  

作　　者：Shrouq Khazaaleh Sumbal Babar Mohammad Alomari Zaid Imam Pravallika Chadalavada Adalberto Jose Gonzalez Bara El Kurdi 

机构地区：[1]Department of Internal Medicine,Cleveland Clinic Fairview Hospital,Cleveland,OH 44126,United States [2]Department of Internal Medicine-Infectious Diseases Division,University of Texas Health Science Center at San Antonio,San Antonio,TX 78249,United States [3]Department of Gastroenterology and Hepatology,Cleveland Clinic Florida,Weston,FI 33324,United States [4]Department of Gastroenterology and Hepatology,William Beaumont Hospital,Royal Oak,MI 48073,United States [5]Department of Gastroenterology and Hepatology,Cleveland Clinic Florida,Weston,FI 33331,United States [6]Department of Gastroenterology and Hepatology,University of Texas Health Science Center at San Antonio,San Antonio,TX 78249,United States

出　　处：《World Journal of Transplantation》2023年第1期10-24,共15页世界移植杂志

摘　　要：BACKGROUND Despite the increased use of total pancreatectomy with islet autotransplantation(TPIAT),systematic evidence of its outcomes remains limited.AIM To evaluate the outcomes of TPIAT.METHODS We searched PubMed,EMBASE,and Cochrane databases from inception through March 2019 for studies on TPIAT outcomes.Data were extracted and analyzed using comprehensive meta-analysis software.The random-effects model was used for all variables.Heterogeneity was assessed using the I2 measure and Cochrane Q-statistic.Publication bias was assessed using Egger’s test.RESULTS Twenty-one studies published between 1980 and 2017 examining 1011 patients were included.Eighteen studies were of adults,while three studied pediatric populations.Narcotic independence was achieved in 53.5%[95% Confidence Interval(CI):45-62,P<0.05,I2=81%]of adults compared to 51.9%(95%CI:17-85,P<0.05,I2=84%)of children.Insulinindependence post-procedure was achieved in 31.8%(95%CI:26-38,P<0.05,I2=64%)of adults with considerable heterogeneity compared to 47.7%(95%CI:20-77,P<0.05,I2=82%)in children.Glycated hemoglobin(HbA1C)12 mo post-surgery was reported in four studies with a pooled value of 6.76%(P=0.27).Neither stratification by age of the studied population nor metaregression analysis considering both the study publication date and the islet-cell-equivalent/kg weight explained the marked heterogeneity between studies.CONCLUSION These results indicate acceptable success for TPIAT.Future studies should evaluate the discussed measures before and after surgery for comparison.

关 键 词：Islet autotransplantation PANCREATECTOMY PANCREATITIS NARCOTICS 

分 类 号：R73[医药卫生—肿瘤]