Total Pancreatectomy With Intraportal Islet Autotransplantation as a Treatment of Chronic Pancreatitis in Patients With CFTR Mutations
| Autor: | Jordan M. Dunitz, David E.R. Sutherland, Sarah Jane Schwarzenberg, Ty B. Dunn, Louise Berry, Melena D. Bellin, Timothy L. Pruett, Gregory J. Beilman, Srinath Chinnakotla, Joshua J. Wilhelm, Kristin P. Colling |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism medicine.medical_treatment Islets of Langerhans Transplantation Cystic Fibrosis Transmembrane Conductance Regulator Transplantation Autologous Gastroenterology Cystic fibrosis Young Adult 03 medical and health sciences Pancreatectomy 0302 clinical medicine Endocrinology Pancreatitis Chronic Internal medicine Diabetes mellitus Internal Medicine medicine Humans Child Retrospective Studies geography geography.geographical_feature_category Hepatology business.industry Insulin Middle Aged medicine.disease Islet Autotransplantation Treatment Outcome Child Preschool 030220 oncology & carcinogenesis Mutation Etiology Pancreatitis Female 030211 gastroenterology & hepatology Complication business |
| Zdroj: | Pancreas. 47:238-244 |
| ISSN: | 1536-4828 0885-3177 |
| DOI: | 10.1097/mpa.0000000000000968 |
| Popis: | OBJECTIVES Chronic pancreatitis (CP) is an infrequent but debilitating complication associated with CFTR mutations. Total pancreatectomy with islet autotransplantation (TPIAT) is a treatment option for CP that provides pain relief and preserves β-cell mass, thereby minimizing the complication of diabetes mellitus. We compared outcomes after TPIAT for CP associated with CFTR mutations to CP without CTFR mutations. METHODS All TPIATs performed between 2002 and 2014 were retrospectively reviewed: identifying 20 CFTR homozygotes (cystic fibrosis [CF] patients), 19 CFTR heterozygotes, and 20 age-/sex-matched controls without CFTR mutations. Analysis of variance and χ tests were used to compare groups. RESULTS Baseline demographics were not different between groups. Postoperative glycosylated hemoglobin and C-peptide levels were similar between groups, as were islet yield and rate of postoperative complications. At 1 year, 40% of CF patients, 22% of CFTR heterozygotes, and 35% of control patients were insulin independent. CONCLUSION Total pancreatectomy with islet autotransplantation is a safe, effective treatment option for CF patients with CP, giving similar outcomes for those with other CP etiologies. |
| Databáze: | OpenAIRE |
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