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Age and Disease Duration Impact Outcomes of Total Pancreatectomy and Islet Autotransplant for PRSS1 Hereditary Pancreatitis. Pancreas 2018 Apr;47(4):466-470

Date

03/09/2018

Pubmed ID

29517634

DOI

10.1097/MPA.0000000000001028

Scopus ID

2-s2.0-85044203483 (requires institutional sign-in at Scopus site)   26 Citations

Abstract

OBJECTIVES: We investigated the impact of patient age and disease duration on islet isolation results, diabetes outcomes, and pain outcomes after total pancreatectomy with islet autotransplant (TPIAT) performed in 64 patients with hereditary pancreatitis due to PRSS1 gene mutation.

METHODS: We evaluated the association of patient age and disease duration on islet isolation results and opioid use at 1 year using logistic regression and on graft function using 1-way analysis of variance.

RESULTS: Islet mass was negatively associated with increasing age and longer disease duration, with a 13% reduction (95% confidence interval [CI], 3%-22%) and 22% (95% CI, 14%-29%) reduction in islet equivalents per kilogram body weight (IEQ/kg) for each 5 years of age and disease duration, respectively. Full graft function was associated with younger age and shorter duration of disease (P < 0.01). Persistent opioid use (15% of patients at 1 year) increased with age (P = 0.05) and disease duration (P = 0.04).

CONCLUSIONS: The TPIAT outcomes were adversely impacted by older age and prolonged disease. In particular, islet mass is lower and risk of diabetes high in older patients with prolonged disease. This should be considered when counseling this subgroup of TPIAT recipients on expected outcomes.

Author List

Bellin MD, Prokhoda P, Hodges JS, Schwarzenberg SJ, Freeman ML, Dunn TB, Wilhelm JJ, Pruett TL, Kirchner VA, Beilman GJ, Chinnakotla S

Author

Ty Blink Dunn MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Autografts
Female
Humans
Islets of Langerhans Transplantation
Logistic Models
Male
Mutation
Pancreatectomy
Pancreatitis, Chronic
Time Factors
Treatment Outcome
Trypsin
Young Adult