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Pancreas transplantation following total pancreatectomy for chronic pancreatitis.
Clin Transplant 2019; :e13731CT

Abstract

BACKGROUND

Total pancreatectomy for chronic pancreatitis leads to brittle diabetes and challenging glycemic control with half of all patients experiencing severe hypoglycemia, many requiring medical intervention or hospitalization. Pancreas transplantation has the potential to manage both the endocrine and the exocrine insufficiency in this patient population.

METHODS

Between June 1, 2005, and July 1, 2016, 8 patients with brittle diabetes following total pancreatectomy underwent pancreas transplantation. All grafts had systemic venous and enteric exocrine drainage. Data included demographics, graft and patient survival, pre- and post-transplant supplementation with pancreatic enzymes, and narcotic usage.

RESULTS

Patient survival rate at 1 and 3 years was 88%. Pancreas graft survival rate of those alive at 1 year was 100% and 86%, respectively. About 75% of these patients remained insulin-free until their time of death, loss of follow-up, or present day. Of the patients with maintained graft function at 3 years, none required further hospitalization for glycemic control. About 75% of these patients have also maintained exocrine function without pancreatic enzyme supplementation.

CONCLUSIONS

Pancreas transplant can treat both exocrine and endocrine insufficiency and give long-term insulin-free survival and should be considered as a viable treatment option for patients who have undergone total pancreatectomy for chronic pancreatitis.

Authors+Show Affiliations

Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31627258

Citation

Cerise, Adam, et al. "Pancreas Transplantation Following Total Pancreatectomy for Chronic Pancreatitis." Clinical Transplantation, 2019, pp. e13731.
Cerise A, Nagaraju S, Powelson JA, et al. Pancreas transplantation following total pancreatectomy for chronic pancreatitis. Clin Transplant. 2019.
Cerise, A., Nagaraju, S., Powelson, J. A., Lutz, A., & Fridell, J. A. (2019). Pancreas transplantation following total pancreatectomy for chronic pancreatitis. Clinical Transplantation, pp. e13731. doi:10.1111/ctr.13731.
Cerise A, et al. Pancreas Transplantation Following Total Pancreatectomy for Chronic Pancreatitis. Clin Transplant. 2019 Oct 18;e13731. PubMed PMID: 31627258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pancreas transplantation following total pancreatectomy for chronic pancreatitis. AU - Cerise,Adam, AU - Nagaraju,Santosh, AU - Powelson,John A, AU - Lutz,Andrew, AU - Fridell,Jonathan A, Y1 - 2019/10/18/ PY - 2019/07/12/received PY - 2019/09/26/revised PY - 2019/09/28/accepted PY - 2019/10/19/pubmed PY - 2019/10/19/medline PY - 2019/10/19/entrez SP - e13731 EP - e13731 JF - Clinical transplantation JO - Clin Transplant N2 - BACKGROUND: Total pancreatectomy for chronic pancreatitis leads to brittle diabetes and challenging glycemic control with half of all patients experiencing severe hypoglycemia, many requiring medical intervention or hospitalization. Pancreas transplantation has the potential to manage both the endocrine and the exocrine insufficiency in this patient population. METHODS: Between June 1, 2005, and July 1, 2016, 8 patients with brittle diabetes following total pancreatectomy underwent pancreas transplantation. All grafts had systemic venous and enteric exocrine drainage. Data included demographics, graft and patient survival, pre- and post-transplant supplementation with pancreatic enzymes, and narcotic usage. RESULTS: Patient survival rate at 1 and 3 years was 88%. Pancreas graft survival rate of those alive at 1 year was 100% and 86%, respectively. About 75% of these patients remained insulin-free until their time of death, loss of follow-up, or present day. Of the patients with maintained graft function at 3 years, none required further hospitalization for glycemic control. About 75% of these patients have also maintained exocrine function without pancreatic enzyme supplementation. CONCLUSIONS: Pancreas transplant can treat both exocrine and endocrine insufficiency and give long-term insulin-free survival and should be considered as a viable treatment option for patients who have undergone total pancreatectomy for chronic pancreatitis. SN - 1399-0012 UR - https://www.unboundmedicine.com/medline/citation/31627258/Pancreas_Transplantation_for_Chronic_Pancreatitis_Following_Total_Pancreatectomy L2 - https://doi.org/10.1111/ctr.13731 DB - PRIME DP - Unbound Medicine ER -