Age and disease duration impact outcomes of total pancreatectomy and islet autotransplant for PRSS1 hereditary pancreatitis

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3 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)466-470
Number of pages5
JournalPancreas
Volume47
Issue number4
DOIs
StatePublished - Apr 1 2018

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Pancreatectomy
Autografts
Opioid Analgesics
Confidence Intervals
Transplants
Hereditary pancreatitis
Counseling
Analysis of Variance
Logistic Models
Body Weight
Pain
Mutation

Keywords

  • Acute pancreatitis
  • Chronic pancreatitis
  • Diabetes
  • HbA1c - hemoglobin A1c
  • Hereditary pancreatitis
  • IN - islet number
  • PRSS1
  • PRSS1 - protease serine 1
  • TPIAT - total pancreatectomy with islet autotransplant
  • Total pancreatectomy

PubMed: MeSH publication types

  • Journal Article

Cite this

@article{e8c31ea7778b48e9a2f0bd13d171e9ec,
title = "Age and disease duration impact outcomes of total pancreatectomy and islet autotransplant for PRSS1 hereditary pancreatitis",
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.",
keywords = "Acute pancreatitis, Chronic pancreatitis, Diabetes, HbA1c - hemoglobin A1c, Hereditary pancreatitis, IN - islet number, PRSS1, PRSS1 - protease serine 1, TPIAT - total pancreatectomy with islet autotransplant, Total pancreatectomy",
author = "Bellin, {Melena D.} and Polina Prokhoda and Hodges, {James S.} and Schwarzenberg, {Sarah J.} and Freeman, {Martin L.} and Dunn, {Ty B.} and Wilhelm, {Joshua J.} and Pruett, {Timothy L.} and Kirchner, {Varvara A.} and Beilman, {Gregory J.} and Srinath Chinnakotla",
year = "2018",
month = "4",
day = "1",
doi = "10.1097/MPA.0000000000001028",
language = "English (US)",
volume = "47",
pages = "466--470",
journal = "Pancreas",
issn = "0885-3177",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Age and disease duration impact outcomes of total pancreatectomy and islet autotransplant for PRSS1 hereditary pancreatitis

AU - Bellin, Melena D.

AU - Prokhoda, Polina

AU - Hodges, James S.

AU - Schwarzenberg, Sarah J.

AU - Freeman, Martin L.

AU - Dunn, Ty B.

AU - Wilhelm, Joshua J.

AU - Pruett, Timothy L.

AU - Kirchner, Varvara A.

AU - Beilman, Gregory J.

AU - Chinnakotla, Srinath

PY - 2018/4/1

Y1 - 2018/4/1

N2 - 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.

AB - 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.

KW - Acute pancreatitis

KW - Chronic pancreatitis

KW - Diabetes

KW - HbA1c - hemoglobin A1c

KW - Hereditary pancreatitis

KW - IN - islet number

KW - PRSS1

KW - PRSS1 - protease serine 1

KW - TPIAT - total pancreatectomy with islet autotransplant

KW - Total pancreatectomy

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U2 - 10.1097/MPA.0000000000001028

DO - 10.1097/MPA.0000000000001028

M3 - Article

VL - 47

SP - 466

EP - 470

JO - Pancreas

JF - Pancreas

SN - 0885-3177

IS - 4

ER -