Islet cell autotransplantation after subtotal pancreatectomy.

Six patients, ranging in age from 28 to 41 years, five men and one woman, underwent 80% to 95% pancreatectomy for chronic pancreatitis, with subsequent autotransplantation of pancreatic fragments. The technique for isolation of pancreatic fragments containing islets of Langerhans was extrapolated from previous experimental work. The follow-up period ranged from one to 25 months. Normal or near-normal carbohydrate metabolism was observed in each patient after the autotransplantation procedure; however, only two patients were insulin independent at 25 and 20 months. One patient died one month after pancreatectomy and autotransplantation of disseminated intravascular coagulation, and another died at three months of surgical complications and sepsis. The remaining two patients were alive and insulin dependent at nine and 25 months. Further developments in islet cell autotransplantation techniques are necessary to achieve, if possible, an insulin-independent status and avert surgically induced diabetes mellitus after total or subtotal pancreatectomy.