P.107: Safety of Islet Transplantation in the Preperitoneal Space in Addition to Intraportal Infusion in Clinical Total Pancreatectomy With Islet Autotransplantation

Onaca, Nicholas; Kumano, Kenjiro; Mattke, Jordan; Darden, Carly M.; Vasu, Srividya; Liu, Yang; Lawrence, Michael C.; Coluzzi, Mariagrazia; Testa, Giuliano; Gupta, Amar; Beecherl, Ernest; Naziruddin, Bashoo

doi:10.1097/01.tp.0000804516.65092.91

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“…If the portal venous pressure were to remain elevated, the remaining pellet may be infused intraperitoneally, which appears to be a safe alternative in patients who do not tolerate the full intraportal infusion, although larger studies are needed. 23 We performed a subanalysis of patients with postdigestion tissue volume >15 mL to compare those who had purification to those who did not have purification. We did not appreciate any statistically significant differences between the 2 groups in regard to postoperative complications and primary or secondary outcomes up to 3-y postoperative.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Intraoperative Versus Dedicated Islet Cell Laboratory Isolation for Total Pancreatectomy With Islet Autotransplant

Navas

Smith

Chaidarun

et al. 2022

Transplantation Direct

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Background. Total pancreatectomy with islet autotransplantation (TPIAT) requires a complex islet isolation process of the explanted pancreas. Islet isolation has historically required a specialized laboratory to perform islet isolation. We report our experience with a novel technique of intraoperative islet isolation that does not require a specialized islet laboratory, thereby making the isolation process simpler, more accessible, and less costly. Methods. We performed a retrospective, comparative effectiveness analysis of 50 adult patients who underwent TPIAT from 2012 to 2020 (TPIAT with remote isolation [n = 20] versus intraoperative isolation of islet cells [n = 30]). The primary outcome was islet equivalents per body weight (IEQ/kg) for patients in each group. Results. Mean IEQ/kg‘s (4294 remote group versus 3015 intraoperative group, P = 0.06) and 1-y postoperative C-peptide levels (1.51 ng/mL remote group versus 0.91 ng/mL intraoperative group, P = 0.10) were not different between groups. Mean 1-y HbA1c levels (7.7% in the remote group versus 7.1% intraoperative group, P = 0.67) and 1-y insulin requirements (P = 0.31) were not statistically different. Lower average cost of hospitalization was seen in the intraoperative group, although this was not statistically significant ($104 398 remote versus $78 986 intraoperative, P = 0.81). Conclusions. Intraoperative islet isolation has similar effectiveness in regard to glycemic outcomes compared with the use of a dedicated islet cell isolation laboratory at a lower cost.

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Section: Discussionmentioning

confidence: 99%