Islet autotransplantation to preserve beta cell mass in selected patients with chronic pancreatitis and diabetes mellitus undergoing total pancreatectomy

Melena D. Bellin, Gregory J. Beilman, Ty B. Dunn, Timothy L. Pruett, Srinath Chinnakotla, Joshua J. Wilhelm, Anh Ngo, David M. Radosevich, Martin L. Freeman, Sarah J. Schwarzenberg, A. N. Balamurugan, Bernhard J. Hering, David E R Sutherland

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Objective: Islet autotransplantation (IAT) is performed in nondiabetic patients with chronic pancreatitis at the time of total pancreatectomy (TP) to minimize risk of postoperative diabetes. The role of TP-IAT in patients with chronic pancreatitis and C-peptide-positive diabetes is not established. We postulate that IAT can preserve beta cell mass and thereby benefit patients with preexisting diabetes undergoing TP. METHODS: Preoperative metabolic testing, islet isolation outcomes, and subsequent islet graft function were reviewed for 27 patients with diabetes mellitus and chronic pancreatitis undergoing TP-IAT. The relationships between the results of preoperative metabolic testing and islet isolation outcomes were explored using regression analysis. RESULTS: Mean islet yield was 2060 (SD, 2408) islet equivalents/kg. Peak C-peptide (from mixed meal tolerance testing) was the strongest predictor of islet yield, with higher stimulated C-peptide levels associated with greater islet mass. Half of the patients who had C-peptide levels measured after transplantation demonstrated C-peptide production at a level that conveys protective benefit in type 1 diabetes (≥0.6 ng/mL). CONCLUSIONS: These findings provide proof of concept that significant islet mass can be isolated in patients with chronic pancreatitis and C-peptide-positive diabetes mellitus undergoing TP-IAT. Stimulated C-peptide may be a useful marker of islet mass before transplantation in these patients.

Original languageEnglish (US)
Pages (from-to)317-321
Number of pages5
JournalPancreas
Volume42
Issue number2
DOIs
StatePublished - Mar 2013

Keywords

  • beta cell
  • diabetes
  • islet
  • pancreatitis
  • transplant

Fingerprint Dive into the research topics of 'Islet autotransplantation to preserve beta cell mass in selected patients with chronic pancreatitis and diabetes mellitus undergoing total pancreatectomy'. Together they form a unique fingerprint.

Cite this