Islet autotransplantation and total pancreatectomy

Abstract

The goal of IAT is the preservation of beta-cell mass at the time of pancreatectomy. The majority of recipients have significant endogenous beta-cell function with positive blood C-peptide after surgery, even if only approximately one third achieve insulin independence. In appropriately selected patients, total pancreatectomy combined with IAT achieves relief of pain and improves quality of life with relatively easier-to-manage glycemic control and avoidance of hyper- and hypoglycemic episodes. Current research is focused on improving techniques of islet isolation and engraftment as well as long-term survival of autografted islets.

Fig 1

Transplantation of islets in patients with chronic pancreatitis.

Fig 2

A) Excised pancreas (a head and a body with tail) from a patient with chronic pancreatitis. Pancreatic duct is cannulated with angiocath allowing for subsequent perfusion with collagenase and organ digestion. B) View of the tissue after pancreas digestion seen in light microscopy. Islets stained with dithizone are in red and acinar tissue remains unstained in yellow-brown. (Magnification 30×).