Kesseli Samuel J, Smith Kerrington D, Jung Min K, Lin Yu K, Walsh R Matthew, Hatipoglu Betul, Axelrod David A, Chaidarun Sushela S, Stevens Tyler K, Gardner Timothy B
From the Sections of *Gastroenterology and Hepatology and †General Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH; ‡Section of Gastroenterology and Hepatology, Digestive Disease Institute, §Department of Endocrinology, Endocrinology and Metabolism Institute, and ∥Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH; and Sections of ¶Transplant Surgery and #Endocrinology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
Pancreas. 2017 Mar;46(3):380-384. doi: 10.1097/MPA.0000000000000792.
Total pancreatectomy with islet autotransplantation is increasingly being performed remotely, that is, removing the pancreas in 1 location, isolating the islet cells in another location, then returning the islets to the original location for reimplantation into the patient. We determined the influence of extended cold ischemia time on key clinical outcomes in remote islet autotransplantation.
We evaluated patients who underwent remote islet autotransplantation at 2 centers from 2011 to 2014. Patients were divided into 2 groups: those with and those without a decrease in C-peptide greater than 50% from baseline. The primary clinical outcome was the quantity of isolated islet equivalents per kilogram body weight (IEQs/kg).
Twenty-five patients met inclusion criteria; 15 had a decrease in C-peptide greater than 50% from baseline and had lower corresponding IEQs/kg compared with those without a decrease greater than 50% (4045 vs 6654 IEQs/kg, P = 0.01). There was no difference in cold ischemia time between the 2 groups (664 vs 600 minutes, P = 0.25). Daily insulin use at 1 year nearly met statistical significance (25.3 vs 8 U, P = 0.06), as did glycated hemoglobin (8.07 vs 6.69 mmol/L, P = 0.06).
Cold ischemia time does not influence islet yield in patients undergoing pancreatectomy with remote isolation.
全胰切除联合胰岛自体移植越来越多地在异地进行，即在一个地点切除胰腺，在另一个地点分离胰岛细胞，然后将胰岛返回原地点重新植入患者体内。我们确定了延长冷缺血时间对异地胰岛自体移植关键临床结局的影响。
我们评估了2011年至2014年在2个中心接受异地胰岛自体移植的患者。患者分为2组：C肽从基线水平下降超过50%的患者和未下降超过50%的患者。主要临床结局是每千克体重分离的胰岛当量数量（IEQs/kg）。
25例患者符合纳入标准；15例C肽从基线水平下降超过50%，与未下降超过50%的患者相比，其相应的IEQs/kg较低（4045对6654 IEQs/kg，P = 0.01）。两组之间的冷缺血时间无差异（664对600分钟，P = 0.25）。1年时的每日胰岛素使用量接近统计学意义（25.3对8 U，P = 0.06），糖化血红蛋白也是如此（8.07对6.69 mmol/L，P = 0.06）。
冷缺血时间不影响接受异地分离的全胰切除患者的胰岛产量。
