OBJECTIVES: We investigated the impact of patient age and disease duration on islet isolation results, diabetes outcomes, and pain outcomes after total pancreatectomy with islet autotransplant (TPIAT) performed in 64 patients with hereditary pancreatitis due to PRSS1 gene mutation. METHODS: We evaluated the association of patient age and disease duration on islet isolation results and opioid use at 1 year using logistic regression and on graft function using 1-way analysis of variance. RESULTS: Islet mass was negatively associated with increasing age and longer disease duration, with a 13% reduction (95% confidence interval [CI], 3%-22%) and 22% (95% CI, 14%-29%) reduction in islet equivalents per kilogram body weight (IEQ/kg) for each 5 years of age and disease duration, respectively. Full graft function was associated with younger age and shorter duration of disease (P < 0.01). Persistent opioid use (15% of patients at 1 year) increased with age (P = 0.05) and disease duration (P = 0.04). CONCLUSIONS: The TPIAT outcomes were adversely impacted by older age and prolonged disease. In particular, islet mass is lower and risk of diabetes high in older patients with prolonged disease. This should be considered when counseling this subgroup of TPIAT recipients on expected outcomes.
OBJECTIVES: We investigated the impact of patient age and disease duration on islet isolation results, diabetes outcomes, and pain outcomes after total pancreatectomy with islet autotransplant (TPIAT) performed in 64 patients with hereditary pancreatitis due to PRSS1 gene mutation. METHODS: We evaluated the association of patient age and disease duration on islet isolation results and opioid use at 1 year using logistic regression and on graft function using 1-way analysis of variance. RESULTS: Islet mass was negatively associated with increasing age and longer disease duration, with a 13% reduction (95% confidence interval [CI], 3%-22%) and 22% (95% CI, 14%-29%) reduction in islet equivalents per kilogram body weight (IEQ/kg) for each 5 years of age and disease duration, respectively. Full graft function was associated with younger age and shorter duration of disease (P < 0.01). Persistent opioid use (15% of patients at 1 year) increased with age (P = 0.05) and disease duration (P = 0.04). CONCLUSIONS: The TPIAT outcomes were adversely impacted by older age and prolonged disease. In particular, islet mass is lower and risk of diabetes high in older patients with prolonged disease. This should be considered when counseling this subgroup of TPIAT recipients on expected outcomes.
Authors: Jaimie D Nathan; Yi Yang; Anne Eaton; Piotr Witkowski; Martin Wijkstrom; Matthew Walsh; Guru Trikudanathan; Vikesh K Singh; Sarah J Schwarzenberg; Timothy L Pruett; Andrew Posselt; Bashoo Naziruddin; Sri Prakash Mokshagundam; Katherine Morgan; Luis F Lara; Varvara Kirchner; Jin He; Timothy B Gardner; Martin L Freeman; Kate Ellery; Darwin L Conwell; Srinath Chinnakotla; Gregory J Beilman; Syed Ahmad; Maisam Abu-El-Haija; James S Hodges; Melena D Bellin Journal: Pancreatology Date: 2021-09-29 Impact factor: 3.996
Authors: A R G Sheel; R D Baron; L D Dickerson; P Ghaneh; F Campbell; M G T Raraty; V Yip; C M Halloran; J P Neoptolemos Journal: Langenbecks Arch Surg Date: 2019-11-20 Impact factor: 3.445
Authors: Guru Trikudanathan; B Joseph Elmunzer; Yi Yang; Maisam Abu-El-Haija; David Adams; Syed Ahmad; Appakalai N Balamurugan; Gregory J Beilman; Srinath Chinnakotla; Darwin L Conwell; Martin L Freeman; Timothy B Gardner; Betul Hatipoglu; James S Hodges; Varvara Kirchner; Luis F Lara; Leslie Long-Simpson; Rebecca Mitchell; Katherine Morgan; Jaimie D Nathan; Bashoo Naziruddin; Andrew Posselt; Timothy L Pruett; Sarah J Schwarzenberg; Vikesh K Singh; Kerrington Smith; Martin Wijkstrom; Piotr Witkowski; Melena D Bellin Journal: Pancreatology Date: 2020-11-24 Impact factor: 3.996
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