TY - JOUR
T1 - Safety and Clinical Outcomes of Using Low-Molecular-Weight Dextran during Islet Autotransplantation in Children
AU - Ali, Hawa M.
AU - Bellin, Melena D.
AU - Boucher, Alexander A.
AU - Northup, Elise F.
AU - Florek, Ellen R.
AU - Wilhelm, Josh
AU - Downs, Elissa M.
AU - Schwarzenberg, Sarah Jane
AU - Chinnakotla, Srinath
N1 - Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - OBJECTIVES: The objective of this study was to evaluate potential safety and clinical benefit of low-molecular-weight dextran (dextran) use in patients undergoing total pancreatectomy with islet auto transplantation (TPIAT).METHODS: We evaluated 124 children undergoing TPIAT at a single institution, either with (n = 72) or without (n = 52) perioperative dextran infusion. Data on islet graft function and postoperative complications were collected through electronic medical records and patient-reported outcomes from research questionnaires.RESULTS: Islet graft failure was less likely at 1 year (odds ratio, 0.186; 95% confidence interval, 0.04-0.65) and 2 years (odds ratio, 0.063; 95% confidence interval, 0.003-0.35) post-TPIAT in the dextran group. This finding remained significant at 2 years in multivariate logistic regression modeling adjusting for islet mass, body surface area, and sex. Likewise, in multivariate regression, the odds of partial islet graft function were higher at 1 and 2 years in the dextran group. Dextran use was overall safe, although it did lead to a higher incidence of postoperative bleeding requiring blood transfusions (P < 0.001).CONCLUSIONS: These findings suggest that dextran use may increase the likelihood for sustained post-TPIAT islet graft function, potentially mitigating severity of postoperative diabetes for these children.
AB - OBJECTIVES: The objective of this study was to evaluate potential safety and clinical benefit of low-molecular-weight dextran (dextran) use in patients undergoing total pancreatectomy with islet auto transplantation (TPIAT).METHODS: We evaluated 124 children undergoing TPIAT at a single institution, either with (n = 72) or without (n = 52) perioperative dextran infusion. Data on islet graft function and postoperative complications were collected through electronic medical records and patient-reported outcomes from research questionnaires.RESULTS: Islet graft failure was less likely at 1 year (odds ratio, 0.186; 95% confidence interval, 0.04-0.65) and 2 years (odds ratio, 0.063; 95% confidence interval, 0.003-0.35) post-TPIAT in the dextran group. This finding remained significant at 2 years in multivariate logistic regression modeling adjusting for islet mass, body surface area, and sex. Likewise, in multivariate regression, the odds of partial islet graft function were higher at 1 and 2 years in the dextran group. Dextran use was overall safe, although it did lead to a higher incidence of postoperative bleeding requiring blood transfusions (P < 0.001).CONCLUSIONS: These findings suggest that dextran use may increase the likelihood for sustained post-TPIAT islet graft function, potentially mitigating severity of postoperative diabetes for these children.
KW - TPIAT
KW - dextran
KW - pediatric
KW - transplant
UR - http://www.scopus.com/inward/record.url?scp=85087114617&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85087114617&partnerID=8YFLogxK
U2 - 10.1097/MPA.0000000000001571
DO - 10.1097/MPA.0000000000001571
M3 - Article
C2 - 32541632
AN - SCOPUS:85087114617
SN - 0885-3177
VL - 49
SP - 774
EP - 780
JO - Pancreas
JF - Pancreas
IS - 6
ER -
