Article Text

  1. M. Salehi,
  2. H. R. Rilo,
  3. S. A. Ahmad,
  4. J. B. Matthews,
  5. A. M. Lowy,
  6. D. A. D'Alessio
  1. Cincinnati, OH


Surgical resection of the pancreas is often used to treat incapacitating abdominal pain in chronic pancreatitis, although it results in insulin deficiency and diabetes. Islet autotransplantation potentially can prevent the onset of diabetes or lessen the severity of diabetes. This procedure has been offered in our center since 2000. Fourteen patients (3 males and 13 females) have been evaluated for beta cell function and oral glucose tolerance test before and after transplantation (3-4 months). The cause of pancreatitis was alcohol related in 2 and idiopathic in 12. All of the patients needed regular opioid use for pain. The average number of islets isolated for transplantation was 3977 ± 1782 IE/kg (range: 1352-8321). Preoperatively none of the patients were treated for diabetes. However 4 patients had impaired glucose tolerance and 5 had diabetes detected on an oral glucose tolerance test (OGT). After surgery all of the patients had a substantial reduction in pain from pancreatitis and 80% no longer required opioids. Four patients did not require treatment for diabetes while 9 were treated with 0.3 ± 0.04 units/kg (range: 0.1-0.4) of insulin, even though all had impaired oral glucose tolerance test. There were no hospitalizations related to diabetes. Comparison of post-transplant and pre-transplant values demonstrated a reduced beta cell function, determined by a lower mean C-peptide response to both arginine (13 ± 6 vs 5 ± 4 ng/mL•min; p<0.05) and oral glucose (3061 ± 1845 vs 1493 ± 1137 ng/mL•min; p<0.05). In our cohort, islet autotransplantation did not prevent diabetes in the majority of patients, although beta cell function was moderately preserved in all of them.

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