Gumpei Yoshimatsu1, Rauf Shahbazov2, Giovanna Saracino3, Michael C Lawrence4, Peter T Kim5, Nicholas Onaca6, Ernest E Beecherl7, Bashoo Naziruddin8, Marlon F Levy9. 1. Islet Cell Laboratory, Baylor Research Institute, 3310 Live Oak Street, Dallas, TX 75204, USA. Electronic address: Gumpei.Yoshimatsu@BSWHealth.org. 2. Department of Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA 22909, USA. Electronic address: rs2vj@virginia.edu. 3. Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Giovanna.Saracino@BSWHealth.org. 4. Islet Cell Laboratory, Baylor Research Institute, 3310 Live Oak Street, Dallas, TX 75204, USA. Electronic address: Michael.Lawrence@BSWHealth.org. 5. Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Peter.Kim@BSWHealth.org. 6. Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Nicholas.Onaca@BSWHealth.org. 7. Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Ernest.Beecherl@BSWHealth.org. 8. Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 950, Dallas, TX 75246, USA. Electronic address: Bashoo.Naziruddin@BSWHealth.org. 9. Transplant Division, Department of Surgery, Virginia Commonwealth University Medical Center, 1200 East Marshall Street, Richmond, VA 23298, USA. Electronic address: marlon.levy@vcuhealth.org.
Abstract
BACKGROUND: Allogenic blood transfusion (ABT) may be needed for severe bleeding during total pancreatectomy with autotransplantation (TPIAT), but may induce inflammation. This study investigated the impact of ABT. METHODS: With a population of 83 patients who underwent TPIAT from 2006 to 2014, this study compared cytokine levels, patient characteristics, islet characteristics, metabolic outcomes, insulin requirements, and hemoglobin A1c for those who received a blood transfusion (BT) versus no blood transfusion (NBT). RESULTS: Initially, proinflammatory cytokines were moderately higher in the BT group than the NBT group. Despite longer procedures and more severe bleeding, the BT group had similar values to the NBT group for insulin requirements, serum C-peptide, hemoglobin A1c, and insulin independence rate. The probability of insulin independence was slightly higher in patients receiving ≥3 units of blood. CONCLUSION: ABT induced elevation of proinflammatory cytokines during the perioperative period in TPIAT, but these changes did not significantly change posttransplant islet function.
BACKGROUND: Allogenic blood transfusion (ABT) may be needed for severe bleeding during total pancreatectomy with autotransplantation (TPIAT), but may induce inflammation. This study investigated the impact of ABT. METHODS: With a population of 83 patients who underwent TPIAT from 2006 to 2014, this study compared cytokine levels, patient characteristics, islet characteristics, metabolic outcomes, insulin requirements, and hemoglobin A1c for those who received a blood transfusion (BT) versus no blood transfusion (NBT). RESULTS: Initially, proinflammatory cytokines were moderately higher in the BT group than the NBT group. Despite longer procedures and more severe bleeding, the BT group had similar values to the NBT group for insulin requirements, serum C-peptide, hemoglobin A1c, and insulin independence rate. The probability of insulin independence was slightly higher in patients receiving ≥3 units of blood. CONCLUSION:ABT induced elevation of proinflammatory cytokines during the perioperative period in TPIAT, but these changes did not significantly change posttransplant islet function.
Authors: Julie R McSwain; Madeline Nykamp; Bethany J Wolf; Jeffrey D McMurray; Christopher A Skorke; Carlee A Clark Journal: Pancreas Date: 2019-02 Impact factor: 3.327