Baylor Research Institute Fort Worth Campus, Fort-Worth, TX 76104, USA.
Cell Transplant. 2011;20(2):313-22. doi: 10.3727/096368910X514611. Epub 2010 Aug 17.
Total pancreatectomy with autologous islet cell transplantation (TP with AIT) is an effective treatment for chronic pancreatitis patients with severe abdominal pain. Body mass index (BMI) of the pancreatic donor is proven to be a useful predictor for islet isolation and transplantation outcomes in allogenic islet transplantation. However, the association between BMI and islet isolation outcome and/or metabolism after AIT was previously unclear. Twelve patients who received TP with AIT at our hospital were included in this study. All pancreata were preserved with both pancreatic ductal injection and oxygen-charged static two-layer method using ET-Kyoto solution. The cohort was divided into two groups: low BMI group (BMI <23 kg/m(2), n=5) and high BMI group (BMI ≥23, n=7). The high BMI group had a significantly higher islet yield per gram than the low BMI group both in pancreas postdigestion and in final product (postdigestion: 7330 ± 539 vs. 3509 ± 563 IE/g; p<0.001; final product: 6555 ± 585 vs. 3476 ± 546 IE/g; p=0.004). For islet yield in final product per patient body weight, the high BMI group also had significantly higher islet yield than the low BMI group (7997 ± 779 vs. 4175 ± 750 IE/kg, p=0.007). Insulin independence rate in the high BMI group (71%) was also higher than that low BMI group (40%), but it did not reach statistical significance. Pancreata from patients with higher BMI could obtain higher islet yield in the setting of autologous islet cell transplantation for chronic pancreatitis.
全胰切除术联合自体胰岛细胞移植(TP 联合 AIT)是治疗慢性胰腺炎伴严重腹痛患者的有效方法。研究证明,供体的体重指数(BMI)是同种异体胰岛移植中胰岛分离和移植结果的有用预测指标。然而,BMI 与 AIT 后胰岛分离结果和/或代谢之间的关系以前并不清楚。本研究纳入了在我院接受 TP 联合 AIT 的 12 例患者。所有胰腺均采用胰管内注射和充氧静态双层法,用 ET-Kyoto 溶液保存。将该队列分为两组:低 BMI 组(BMI<23kg/m2,n=5)和高 BMI 组(BMI≥23,n=7)。高 BMI 组在胰腺消化后和最终产物中的每克胰岛产率均显著高于低 BMI 组(消化后:7330±539 与 3509±563IE/g,p<0.001;最终产物:6555±585 与 3476±546IE/g,p=0.004)。对于每公斤患者体重的最终产物中的胰岛产率,高 BMI 组也显著高于低 BMI 组(7997±779 与 4175±750IE/kg,p=0.007)。高 BMI 组的胰岛素独立性率(71%)也高于低 BMI 组(40%),但未达到统计学意义。在慢性胰腺炎的自体胰岛细胞移植中,BMI 较高的患者胰腺可获得更高的胰岛产率。