Islet Isolation Outcomes in Patients Undergoing Total Pancreatectomy With Islet Autotransplantation in the POST Consortium.

Autor:	Mattke J; Islet Cell Processing Laboratory, Baylor Health, Dallas, TX., Eaton A; Division of Biostatistics and Health Data Science, University of Minnesota School of Public Health, Minneapolis, MN., Wijkstrom M; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA., Witkowski P; The Transplantation Institute, University of Chicago, Chicago, IL., Trikudanathan G; Department of Medicine, University of Minnesota Medical School, Minneapolis, MN., Singh VK; Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD., Schwarzenberg SJ; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN., Ramanathan K; Department of Surgery, University of Minnesota Medical School, Minneapolis, MN., Pruett TL; Department of Surgery, University of Minnesota Medical School, Minneapolis, MN., Posselt A; Department of Surgery, University of California San Francisco, San Francisco, CA., Nathan JD; Department of Pediatric Abdominal Transplant and Hepatopancreatobiliary Surgery, Nationwide Children's Hospital, Columbus, OH., Morgan K; Department of Surgery, The Medical University of South Carolina, Charleston, SC., Mokshagundam SP; Department of Medicine, University of Louisville, Louisville, KY., Lara L; Department of Medicine, The Ohio State Wexner University Medical Center, Columbus, OH., Gardner TB; Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH., Freeman M; Department of Medicine, University of Minnesota Medical School, Minneapolis, MN., Downs E; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN., Chinnakotla S; Department of Surgery, University of Minnesota Medical School, Minneapolis, MN., Beilman GJ; Department of Surgery, University of Minnesota Medical School, Minneapolis, MN., Ahmad S; Department of Surgery, University of Cincinnati, Cincinnati, OH., Adams D; Department of Surgery, The Medical University of South Carolina, Charleston, SC., Abu-El-Haija M; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH., Naziruddin B; Islet Cell Processing Laboratory, Baylor Health, Dallas, TX., Bellin MD; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN.; Department of Surgery, University of Minnesota Medical School, Minneapolis, MN.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2025 Jan 01; Vol. 109 (1), pp. 207-216. Date of Electronic Publication: 2024 Dec 07.
DOI:	10.1097/TP.0000000000005127
Abstrakt:	Background: In total pancreatectomy with islet autotransplantation (TPIAT), a greater number of islets transplanted produces more favorable outcomes. We aimed to determine predictors of islet isolation outcomes. Methods: We investigated factors associated with islet isolation outcomes expressed as islet number (IN), islet equivalents (IEQ; standardized to an islet with 150 μm diameter), IN/kg, or IEQ/kg using data from the multicenter Prospective Observational Study of TPIAT. Single-predictor linear regression was used to estimate the association of individual patient and disease characteristics with islet isolation outcomes, and augmented backward elimination was used to select variables to include in multivariable analyses. Results: In multivariable analyses, only elevated hemoglobin A1c was associated with worse outcomes for all measures ( P  < 0.001 for all). Total IEQ obtained for transplant was higher for participants with Hispanic ethnicity ( P  = 0.002) or overweight status pre-TPIAT ( P  < 0.001) and lower with non-White race ( P  = 0.03), genetic pancreatitis ( P  = 0.02), history of lateral pancreaticojejunostomy ( P  = 0.03), and presence of atrophy ( P  = 0.006) or ductal changes ( P  = 0.014) on imaging. IEQ/kg was higher in females ( P  = 0.01) and Hispanic participants ( P  = 0.046) and generally lower with older age (nonlinear association, P  < 0.001) and pancreatic atrophy ( P  < 0.001) on imaging. Total IN and IN/kg showed trends similar, but not identical, to IEQ and IEQ/kg, respectively. Conclusions: Patient demographics and certain pancreatic disease features were associated with outcomes from islet isolation. Hemoglobin A1c before TPIAT was the metabolic testing measure most strongly associated with islet isolation results. Competing Interests: M.D.B. received research support from Dexcom and Viacyte and had advisory board or consultant roles with Insulet, Vertex, and Emerging Therapy Solutions. G.J.B. was supported by US Army Medical Acquisitions (grant W81XWH1810687). S.J.S. was consultant to UpToDate, Renexxion, Abbvie, and Mirum. The other authors declare no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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