Official Sections CTRMS ISVCA IPITA IPTA ISODP IRTA IXA SPLIT TID

2013 - CTS 2013 Congress


This page contains exclusive content for the member of the following sections: TTS, CTS

Oral Communications 10

21.3 - NEW INDICATIONS FOR ISLET AUTOTRANSPLANTATION IN HUMAN

Presenter: Lorenzo, Piemonti, Milan, Italy
Authors: Gianpaolo Balzano1,2, Paola Maffi1,2, Rita Nano1,2, Alessandro Zerbi1,2, Massimo Venturini1,2, Raffaella Melzi1,2, Alessia Mercalli1,2, Paola Magistretti1,2, Marina Scavini1,2, Renato Castoldi1,2, Massimo Carvello1,2, Marco Braga1,2, Antonio Del Maschio1,2, Antonio Secchi1,2, Carlo Staudacher1,2, Lorenzo Piemonti1,2

NEW INDICATIONS FOR ISLET AUTOTRANSPLANTATION IN HUMAN

Gianpaolo Balzano1,2, Paola Maffi1,2, Rita Nano1,2, Alessandro Zerbi1,2, Massimo Venturini1,2, Raffaella Melzi1,2, Alessia Mercalli1,2, Paola Magistretti1,2, Marina Scavini1,2, Renato Castoldi1,2, Massimo Carvello1,2, Marco Braga1,2, Antonio Del Maschio1,2, Antonio Secchi1,2, Carlo Staudacher1,2, Lorenzo Piemonti1,2

1Diabetes Research Institute (OSR-DRI), San Raffaele Scientific Institute, Milan, Italy; 2San Raffaele Scientific Institute, Milan, Italy

 

Background Data. Islet autotransplantation (IAT) is performed to improve glycemic control after extended pancreatectomy, almost exclusively in patients with chronic pancreatitis. Limited experience is available for other indications or in patients with pancreatic malignancy.
Methods. In addition to chronic pancreatitis, indications for IAT were: grade C pancreatic fistula (treated with completion or left pancreatectomy, as indicated); total pancreatectomy as an alternative to high-risk anastomosis during pancreaticoduodenectomy; distal pancreatectomy for benign/borderline neoplasm of pancreatic body-neck. Malignancy was not an exclusion criterion. Metabolic and oncologic follow-up is presented.
Results. From November 2008 to June 2012, 41 patients were candidates to IAT (accounting for 7.5% of all pancreatic resections). Seven out of 41 did not received transplantation for either inadequate islet mass (4 pts), patient instability (2 pts), contamination of islet culture (1 pt). IAT-related complications occurred in 8 pts (23.5%): 4 bleeding, 3 portal thromboses (1 complete, 2 partial), 1 sepsis. Median follow-up was 546 days. Fifteen out of 34 patients (44%) reached insulin independence, 16 patients (47%) had partial graft function, 2 patients (6%) had primary graft non-function and 1 patient (3%) had early graft loss. Seventeen IAT recipients had malignancy (pancreatic or periampullary adenocarcinoma in 14). Two of them had already liver metastases at surgery, thirteen were disease-free at last follow-up and none of two patients with tumour recurrence developed metastases in the transplantation site.
Conclusions. Though larger data are needed to definitely exclude the risk of disease dissemination, the present study suggest that IAT indications can be extended to selected patients with neoplasm.


Important Disclaimer

By viewing the material on this site you understand and accept that:

  1. The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
  2. The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
  3. The material is solely for educational purposes for qualified health care professionals.
  4. The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
  5. The information cannot be used as a substitute for professional care.
  6. The information does not represent a standard of care.
  7. No physician-patient relationship is being established.

Social

Contact

Staff Directory
+1-514-874-1717
This email address is being protected from spambots. You need JavaScript enabled to view it.

Address

The Transplantation Society
International Headquarters
505 Boulevard René-Lévesque Ouest
Suite 1401
Montréal, QC, H2Z 1Y7
Canada