Is There a Benefit From Islet Autotransplantation in Patients With Type 1 Diabetes Mellitus Undergoing Total Pancreatectomy?

被引:1
作者
Mun, Kyu Shik [1 ,2 ]
Nathan, Jaimie D. [3 ,4 ,5 ,6 ]
Lin, Tom K. [7 ,8 ]
Elder, Deborah A. [8 ,9 ]
Jegga, Anil G. [8 ,10 ]
Naren, Anjaparavanda P. [11 ]
Abu-El-Haija, Maisam [7 ]
机构
[1] Cedars Sinai Med Ctr, Dept Med, Div Pulm Med, 127 S San Vicente Blvd,AHSP 9314, Los Angeles, CA 90048 USA
[2] Cedars Sinai Med Ctr, Dept Pediat, Board Governors Regenerat Med Inst, Los Angeles, CA 90048 USA
[3] Cincinnati Childrens Hosp Med Ctr, Div Pediat Gen & Thorac Surg, Cincinnati, OH 45229 USA
[4] Univ Cincinnati, Coll Med, Dept Surg, Cincinnati, OH USA
[5] Nationwide Childrens Hosp, Dept Abdominal Transplant & Hepatopancreatobiliar, Columbus, OH USA
[6] Ohio State Univ, Dept Surg, Wexner Med Ctr, Columbus, OH 43210 USA
[7] Cincinnati Childrens Hosp Med Ctr, Div Pediat Gastroenterol Hepatol & Nutr, 3333 Burnet Ave,MLC 2010, Cincinnati, OH 45229 USA
[8] Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati, OH USA
[9] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cyst Fibrosis Res Ctr, Div Endocrinol, Cincinnati, OH 45229 USA
[10] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cyst Fibrosis Res Ctr, Div Biomed Informat, Cincinnati, OH 45229 USA
[11] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cyst Fibrosis Res Ctr, Div Pulm Med, Cincinnati, OH 45229 USA
基金
美国国家卫生研究院;
关键词
total pancreatectomy with islet autotransplantation; type; 1; diabetes; chronic pancreatitis; endocrine function; islets of Langerhans; CHRONIC-PANCREATITIS; ACUTE RECURRENT;
D O I
10.1097/MPA.0000000000002017
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Children with acute recurrent and chronic pancreatitis (CP) experience abdominal pain that leads to hospitalizations, opioid dependence, and poor quality of life. Total pancreatectomy with islet autotransplantation (TPIAT) is offered as a surgical option in management of debilitating pancreatitis that fails medical and endoscopic therapy to reduce or eliminate pain. Given that patients with type 1 diabetes mellitus (T1DM) lack insulin-producing beta cells, the outcomes from autotransplanting islet isolates back into total pancreatectomy patients with T1DM are not fully known. We performed TPIAT in 2 CP patients who also had a diagnosis of T1DM for at least 6 years before the operation and evaluated the clinical and laboratory outcomes before and after the operation. Postoperatively both patients' abdominal pain had significantly subsided, they were weaned off opioid medications, and they were able to return to full-time school attendance. In addition, total daily dose of insulin in 1 patient was able to be slightly reduced at 12 months post-TPIAT. We observed in vitro that residual alpha cells and beta cells in T1DM islets were able to secrete a small amount of glucagon and insulin, respectively.
引用
收藏
页码:399 / 403
页数:5
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