Diabetes-Free Survival in Patients Who Underwent Islet Autotransplantation After 50% to 60% Distal Partial Pancreatectomy for Benign Pancreatic Tumors

作者：Jin Sang Man; Oh Seung Hoon; Kim Soo Kyoung; Jung Hye Seung; Choi Seong Ho; Jang Kee Taek; Lee Kyu Taek; Kim Jae Hyeon; Lee Myung Shik; Lee Moon Kyu; Kim Kwang Won^*

来源：Transplantation, 2013, 95(11): 1396-1403.

DOI：10.1097/TP.0b013e31828c0c29

• Islet transplantation
• Pancreatectomy
• Islet isolation

Background. Several retrospective studies with short-termfollow-up have demonstrated a low rate of new-onset diabetes after distal pancreatectomy for benign pancreatic tumors. We sought to determine the long-termdiabetes-free survival of patients who underwent islet autotransplantation (IAT) after distal pancreatectomy and to identify any associations between the isolation parameters of autologous islets and diabetes-free survival. %26lt;br%26gt;Methods. Among the 37 nondiabetic patients who underwent 50% to 60% partial pancreatectomy, 20 underwent IAT (IAT group; median follow-up period, 61 months). In the IAT group, diabetes-free survival was determined based on annual oral glucose tolerance tests, fasting blood glucose, and hemoglobin A(1C). %26lt;br%26gt;Results. The 7-year diabetes-free survival rate was 51% in the IAT group (median follow-up period, 61 months) and 45% in the 37 study subjects. Diabetes-free survival was significantly prolonged when islet yield per gram of pancreas weight was more than 5154 islet equivalents (IEQ)/g, even in patients with prediabetes and high insulin resistance who had a markedly high rate of diabetes development. The proportion of patients with impaired glucose tolerance at 2 years after distal pancreatectomy was 12 of 16 in the control group, 6 of 7 in patients with islet yields of less than 5154 IEQ/g, and 3 of 11 in patients with islet yields of more than 5154 IEQ/g (P=0.019). %26lt;br%26gt;Conclusions. Partial (50%-60%) pancreatectomy for benign pancreatic tumors had a major metabolic consequence, especially in patients with prediabetes and high insulin resistance. In this setting, prolonged diabetes-free survival was observed in patients who underwent IAT when a high islet yield per gram of pancreas was achieved.

• 出版日期2013-6-15