Safety and Clinical Outcomes of Using Low-Molecular-Weight Dextran during Islet Autotransplantation in Children

Hawa M. Ali, Melena D. Bellin, Alexander A. Boucher, Elise F. Northup, Ellen R. Florek, Josh J. Wilhelm, Elissa M Downs, Sarah J Schwarzenberg, Srinath Chinnakotla

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)774-780
Number of pages7
JournalPancreas
Volume49
Issue number6
DOIs
StatePublished - Jul 1 2020

Keywords

  • dextran
  • pediatric
  • TPIAT
  • transplant

PubMed: MeSH publication types

  • Journal Article

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