• Morihito Takita, Luis F Lara, Bashoo Naziruddin, Rauf Shahbazov, Michael C Lawrence, Peter T Kim, Nicholas Onaca, James S Burdick, and Marlon F Levy.
• Islet Cell Laboratory, Islet Cell Laboratory, Baylor Research Institute, 3410 Worth St. #950, Dallas, TX, 75246, USA, morihito.takita@baylorhealth.edu.
• J. Gastrointest. Surg. 2015 Jul 1; 19 (7): 1236-46.

BackgroundTotal pancreatectomy (TP) with islet autotransplantation (IAT) is a highly selected treatment for severe pain associated with chronic pancreatitis (CP) after exhausting medical and endoscopic therapies. The effect of duration of CP on TP-IAT has not been clarified.MethodsRetrospective review of a consecutive cohort undergoing TP-IAT was performed. Patients were classified according to islet dose of <2500 IEQ/kg, 2500 to 5000 IEQ/kg, and >5000 IEQ/kg. Islet yield and metabolic outcomes were compared to disease duration of CP.ResultsA total of 76 CP patients underwent TP-IAT. Longer disease duration was associated with lower islet yield transplanted (Spearman's correlation = -0.24; p = 0.04) for total cohort. Highest absolute value of the coefficient was found in patients with hereditary CP when study subjects were classified by the etiology of CP (correlation = -0.72; p = 0.02). Higher islet yields were significantly associated with better metabolic outcomes (7.6 ± 1.1 vs 6.6 ± 1.1% of HbA1c post-TPIAT in patients with <2500 and >5000 IEQ/kg transplanted, respectively; p = 0.04).ConclusionsThe duration of CP could affect islet yield and metabolic outcomes. The time since the diagnosis of CP should be considered when selecting patients for islet autotransplantation.

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