Assessment of long-term graft function following total pancreatectomy and autologous islet transplantation:the Leicester experience  

作　　者：Cristina A.Pollard Wen Yuan Chung Giuseppe Garcea Ashley R.Dennison 

机构地区：[1]Department of Hepatobiliary and Pancreatic Surgery,Leicester General Hospital,Leicester,UK

出　　处：《Hepatobiliary Surgery and Nutrition》2023年第5期682-691,I0016,共11页肝胆外科与营养（英文）

摘　　要：Background:Total pancreatectomy and islet autotransplantation(TPIAT)is a recognised treatment for chronic pancreatitis(CP)with the potential to mitigate or prevent pancreatogenic diabetes.We present our 10-year follow-up of TPIAT patients.Methods:The University Hospitals of Leicester performed 60 TPIAT procedures from September 1994 to May 2011.Seventeen patients completed their 10-year assessment and were grouped using the modified Auto-Igls criteria;good response,n=5(insulin-independent for first 5 years post-TPIAT);partial response,n=6(insulin requirements<20 iU/day post-TPIAT)and poor response,n=6(insulin requirements≥20 iU/day post-TPIAT).C-peptide,haemoglobin A1c(HbA1c)and oral glucose tolerance test(OGTT)were undertaken preoperatively(baseline),then at 3,6 months and then yearly for 10 years.Data was analysed using analysis of variance(ANOVA).Results:Median C-peptide levels were significantly higher,120 minutes following OGTT,in the“good response”compared to“partial”and“poor”groups(two-way ANOVA test,P<0.0001).All groups demonstrated preservation of C-peptide release.HbA1c levels were significantly lower in the“good response”compared to“partial”and“poor”groups(two-way ANOVA test,P<0.0003 and P<0.0001).Median fasting glucose levels at 30 and 120 min following OGTT,were significantly lower in the“good response”compared to“partial”and“poor”groups(two-way ANOVA test,P<0.0001 and P<0.0001).Conclusions:TPIAT preserves long-term islet graft functions in 10-year follow up.Even in patients in the poor response group,there is evidence of C-peptide release(>0.5 ng/mL)after OGTT stimulation potentially preventing long-term diabetes-related complications.

关 键 词：Islet autotransplantation(IAT) chronic pancreatitis(CP) C-PEPTIDE 

分 类 号：R657.5[医药卫生—外科学]