Total Pancreatectomy with Intraportal Islet Autotransplantation as a Treatment of Chronic Pancreatitis in Patients with CFTR Mutations

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Abstract

Objectives Chronic pancreatitis (CP) is an infrequent but debilitating complication associated with CFTR mutations. Total pancreatectomy with islet autotransplantation (TPIAT) is a treatment option for CP that provides pain relief and preserves β-cell mass, thereby minimizing the complication of diabetes mellitus. We compared outcomes after TPIAT for CP associated with CFTR mutations to CP without CTFR mutations. Methods All TPIATs performed between 2002 and 2014 were retrospectively reviewed: identifying 20 CFTR homozygotes (cystic fibrosis [CF] patients), 19 CFTR heterozygotes, and 20 age-/sex-matched controls without CFTR mutations. Analysis of variance and χ2 tests were used to compare groups. Results Baseline demographics were not different between groups. Postoperative glycosylated hemoglobin and C-peptide levels were similar between groups, as were islet yield and rate of postoperative complications. At 1 year, 40% of CF patients, 22% of CFTR heterozygotes, and 35% of control patients were insulin independent. Conclusion Total pancreatectomy with islet autotransplantation is a safe, effective treatment option for CF patients with CP, giving similar outcomes for those with other CP etiologies.

Original languageEnglish (US)
Pages (from-to)238-244
Number of pages7
JournalPancreas
Volume47
Issue number2
DOIs
StatePublished - Feb 1 2018

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Pancreatectomy
Autologous Transplantation
Chronic Pancreatitis
Mutation
Cystic Fibrosis
Heterozygote
Therapeutics
C-Peptide
Homozygote
Diabetes Complications
Analysis of Variance
Demography
Insulin
Pain

Keywords

  • cystic fibrosis
  • genetic pancreatitis
  • islet cell transplant
  • pancreatitis

PubMed: MeSH publication types

  • Journal Article

Cite this

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title = "Total Pancreatectomy with Intraportal Islet Autotransplantation as a Treatment of Chronic Pancreatitis in Patients with CFTR Mutations",
abstract = "Objectives Chronic pancreatitis (CP) is an infrequent but debilitating complication associated with CFTR mutations. Total pancreatectomy with islet autotransplantation (TPIAT) is a treatment option for CP that provides pain relief and preserves β-cell mass, thereby minimizing the complication of diabetes mellitus. We compared outcomes after TPIAT for CP associated with CFTR mutations to CP without CTFR mutations. Methods All TPIATs performed between 2002 and 2014 were retrospectively reviewed: identifying 20 CFTR homozygotes (cystic fibrosis [CF] patients), 19 CFTR heterozygotes, and 20 age-/sex-matched controls without CFTR mutations. Analysis of variance and χ2 tests were used to compare groups. Results Baseline demographics were not different between groups. Postoperative glycosylated hemoglobin and C-peptide levels were similar between groups, as were islet yield and rate of postoperative complications. At 1 year, 40{\%} of CF patients, 22{\%} of CFTR heterozygotes, and 35{\%} of control patients were insulin independent. Conclusion Total pancreatectomy with islet autotransplantation is a safe, effective treatment option for CF patients with CP, giving similar outcomes for those with other CP etiologies.",
keywords = "cystic fibrosis, genetic pancreatitis, islet cell transplant, pancreatitis",
author = "Colling, {Kristin P.} and Bellin, {Melena D.} and Schwarzenberg, {Sarah J.} and Louise Berry and Wilhelm, {Joshua J.} and Ty Dunn and Pruett, {Timothy L.} and Sutherland, {David E.R.} and Srinath Chinnakotla and Dunitz, {Jordan M.} and Beilman, {Greg J.}",
year = "2018",
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language = "English (US)",
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journal = "Pancreas",
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T1 - Total Pancreatectomy with Intraportal Islet Autotransplantation as a Treatment of Chronic Pancreatitis in Patients with CFTR Mutations

AU - Colling, Kristin P.

AU - Bellin, Melena D.

AU - Schwarzenberg, Sarah J.

AU - Berry, Louise

AU - Wilhelm, Joshua J.

AU - Dunn, Ty

AU - Pruett, Timothy L.

AU - Sutherland, David E.R.

AU - Chinnakotla, Srinath

AU - Dunitz, Jordan M.

AU - Beilman, Greg J.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Objectives Chronic pancreatitis (CP) is an infrequent but debilitating complication associated with CFTR mutations. Total pancreatectomy with islet autotransplantation (TPIAT) is a treatment option for CP that provides pain relief and preserves β-cell mass, thereby minimizing the complication of diabetes mellitus. We compared outcomes after TPIAT for CP associated with CFTR mutations to CP without CTFR mutations. Methods All TPIATs performed between 2002 and 2014 were retrospectively reviewed: identifying 20 CFTR homozygotes (cystic fibrosis [CF] patients), 19 CFTR heterozygotes, and 20 age-/sex-matched controls without CFTR mutations. Analysis of variance and χ2 tests were used to compare groups. Results Baseline demographics were not different between groups. Postoperative glycosylated hemoglobin and C-peptide levels were similar between groups, as were islet yield and rate of postoperative complications. At 1 year, 40% of CF patients, 22% of CFTR heterozygotes, and 35% of control patients were insulin independent. Conclusion Total pancreatectomy with islet autotransplantation is a safe, effective treatment option for CF patients with CP, giving similar outcomes for those with other CP etiologies.

AB - Objectives Chronic pancreatitis (CP) is an infrequent but debilitating complication associated with CFTR mutations. Total pancreatectomy with islet autotransplantation (TPIAT) is a treatment option for CP that provides pain relief and preserves β-cell mass, thereby minimizing the complication of diabetes mellitus. We compared outcomes after TPIAT for CP associated with CFTR mutations to CP without CTFR mutations. Methods All TPIATs performed between 2002 and 2014 were retrospectively reviewed: identifying 20 CFTR homozygotes (cystic fibrosis [CF] patients), 19 CFTR heterozygotes, and 20 age-/sex-matched controls without CFTR mutations. Analysis of variance and χ2 tests were used to compare groups. Results Baseline demographics were not different between groups. Postoperative glycosylated hemoglobin and C-peptide levels were similar between groups, as were islet yield and rate of postoperative complications. At 1 year, 40% of CF patients, 22% of CFTR heterozygotes, and 35% of control patients were insulin independent. Conclusion Total pancreatectomy with islet autotransplantation is a safe, effective treatment option for CF patients with CP, giving similar outcomes for those with other CP etiologies.

KW - cystic fibrosis

KW - genetic pancreatitis

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