Microbial contamination of transplant solutions during pancreatic islet autotransplants is not associated with clinical infection in a pediatric population

Megan G. Berger, Kaustav Majumder, James S. Hodges, Melena D. Bellin, Sarah Jane Schwarzenberg, Sameer Gupta, Ty B. Dunn, Gregory J. Beilman, Timothy L. Pruett, Martin L. Freeman, Joshua J. Wilhelm, David E R Sutherland, Srinath Chinnakotla

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9 Citations (Scopus)

Abstract

Background/Objectives Total pancreatectomy and islet autotransplant (TP-IAT) is a potential treatment for children with severe refractory chronic pancreatitis. Cultures from the resected pancreas and final islet preparation are frequently positive for microbes. It is unknown whether positive cultures are associated with adverse outcomes in pediatric patients. Methods We reviewed the medical records of children (n = 86) who underwent TP-IAT from May 2006–March 2015 with emphasis on demographics, previous pancreatic interventions, culture results, islet yield, hospital days, posttransplant islet function, and posttransplant infections. We compared outcomes in patients with positive (n = 57) and negative (n = 29) cultures. Results Patients with positive cultures had higher rates of previous pancreas surgery (P = 0.007) and endoscopic retrograde cholangiopancreatography (P < 0.0001). Positive cultures were not associated with posttransplant infections (P = 1.00) or prolonged hospital length of stay (P = 0.29). Patients with positive final islet preparation culture showed increased rates of graft failure at 2 years posttransplant (P = 0.041), but not when adjusted for islet mass transplanted (P = 0.39). Conclusions Positive cultures during pediatric TP-IATs do not increase the risk of posttransplant infections or prolong hospital length of stay. Endocrine function depends on islet mass transplanted.

Original languageEnglish (US)
Pages (from-to)555-562
Number of pages8
JournalPancreatology
Volume16
Issue number4
DOIs
StatePublished - Jul 1 2016

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Autografts
Islets of Langerhans
Length of Stay
Pediatrics
Transplants
Pancreatectomy
Infection
Population
Pancreas
Endoscopic Retrograde Cholangiopancreatography
Chronic Pancreatitis
Medical Records
Demography
Therapeutics

Keywords

  • Chronic pancreatitis
  • Infection
  • Islet autotransplant
  • Pediatric
  • Sterility culture
  • Total pancreatectomy

Cite this

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title = "Microbial contamination of transplant solutions during pancreatic islet autotransplants is not associated with clinical infection in a pediatric population",
abstract = "Background/Objectives Total pancreatectomy and islet autotransplant (TP-IAT) is a potential treatment for children with severe refractory chronic pancreatitis. Cultures from the resected pancreas and final islet preparation are frequently positive for microbes. It is unknown whether positive cultures are associated with adverse outcomes in pediatric patients. Methods We reviewed the medical records of children (n = 86) who underwent TP-IAT from May 2006–March 2015 with emphasis on demographics, previous pancreatic interventions, culture results, islet yield, hospital days, posttransplant islet function, and posttransplant infections. We compared outcomes in patients with positive (n = 57) and negative (n = 29) cultures. Results Patients with positive cultures had higher rates of previous pancreas surgery (P = 0.007) and endoscopic retrograde cholangiopancreatography (P < 0.0001). Positive cultures were not associated with posttransplant infections (P = 1.00) or prolonged hospital length of stay (P = 0.29). Patients with positive final islet preparation culture showed increased rates of graft failure at 2 years posttransplant (P = 0.041), but not when adjusted for islet mass transplanted (P = 0.39). Conclusions Positive cultures during pediatric TP-IATs do not increase the risk of posttransplant infections or prolong hospital length of stay. Endocrine function depends on islet mass transplanted.",
keywords = "Chronic pancreatitis, Infection, Islet autotransplant, Pediatric, Sterility culture, Total pancreatectomy",
author = "Berger, {Megan G.} and Kaustav Majumder and Hodges, {James S.} and Bellin, {Melena D.} and Schwarzenberg, {Sarah Jane} and Sameer Gupta and Dunn, {Ty B.} and Beilman, {Gregory J.} and Pruett, {Timothy L.} and Freeman, {Martin L.} and Wilhelm, {Joshua J.} and Sutherland, {David E R} and Srinath Chinnakotla",
year = "2016",
month = "7",
day = "1",
doi = "10.1016/j.pan.2016.03.019",
language = "English (US)",
volume = "16",
pages = "555--562",
journal = "Pancreatology",
issn = "1424-3903",
publisher = "S. Karger AG",
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TY - JOUR

T1 - Microbial contamination of transplant solutions during pancreatic islet autotransplants is not associated with clinical infection in a pediatric population

AU - Berger, Megan G.

AU - Majumder, Kaustav

AU - Hodges, James S.

AU - Bellin, Melena D.

AU - Schwarzenberg, Sarah Jane

AU - Gupta, Sameer

AU - Dunn, Ty B.

AU - Beilman, Gregory J.

AU - Pruett, Timothy L.

AU - Freeman, Martin L.

AU - Wilhelm, Joshua J.

AU - Sutherland, David E R

AU - Chinnakotla, Srinath

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background/Objectives Total pancreatectomy and islet autotransplant (TP-IAT) is a potential treatment for children with severe refractory chronic pancreatitis. Cultures from the resected pancreas and final islet preparation are frequently positive for microbes. It is unknown whether positive cultures are associated with adverse outcomes in pediatric patients. Methods We reviewed the medical records of children (n = 86) who underwent TP-IAT from May 2006–March 2015 with emphasis on demographics, previous pancreatic interventions, culture results, islet yield, hospital days, posttransplant islet function, and posttransplant infections. We compared outcomes in patients with positive (n = 57) and negative (n = 29) cultures. Results Patients with positive cultures had higher rates of previous pancreas surgery (P = 0.007) and endoscopic retrograde cholangiopancreatography (P < 0.0001). Positive cultures were not associated with posttransplant infections (P = 1.00) or prolonged hospital length of stay (P = 0.29). Patients with positive final islet preparation culture showed increased rates of graft failure at 2 years posttransplant (P = 0.041), but not when adjusted for islet mass transplanted (P = 0.39). Conclusions Positive cultures during pediatric TP-IATs do not increase the risk of posttransplant infections or prolong hospital length of stay. Endocrine function depends on islet mass transplanted.

AB - Background/Objectives Total pancreatectomy and islet autotransplant (TP-IAT) is a potential treatment for children with severe refractory chronic pancreatitis. Cultures from the resected pancreas and final islet preparation are frequently positive for microbes. It is unknown whether positive cultures are associated with adverse outcomes in pediatric patients. Methods We reviewed the medical records of children (n = 86) who underwent TP-IAT from May 2006–March 2015 with emphasis on demographics, previous pancreatic interventions, culture results, islet yield, hospital days, posttransplant islet function, and posttransplant infections. We compared outcomes in patients with positive (n = 57) and negative (n = 29) cultures. Results Patients with positive cultures had higher rates of previous pancreas surgery (P = 0.007) and endoscopic retrograde cholangiopancreatography (P < 0.0001). Positive cultures were not associated with posttransplant infections (P = 1.00) or prolonged hospital length of stay (P = 0.29). Patients with positive final islet preparation culture showed increased rates of graft failure at 2 years posttransplant (P = 0.041), but not when adjusted for islet mass transplanted (P = 0.39). Conclusions Positive cultures during pediatric TP-IATs do not increase the risk of posttransplant infections or prolong hospital length of stay. Endocrine function depends on islet mass transplanted.

KW - Chronic pancreatitis

KW - Infection

KW - Islet autotransplant

KW - Pediatric

KW - Sterility culture

KW - Total pancreatectomy

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U2 - 10.1016/j.pan.2016.03.019

DO - 10.1016/j.pan.2016.03.019

M3 - Article

VL - 16

SP - 555

EP - 562

JO - Pancreatology

JF - Pancreatology

SN - 1424-3903

IS - 4

ER -