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. 2023 Jan 18;13(1):10-24.
doi: 10.5500/wjt.v13.i1.10.

Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis

Shrouq Khazaaleh  1 , Sumbal Babar  2 , Mohammad Alomari  3 , Zaid Imam  4 , Pravallika Chadalavada  5 , Adalberto Jose Gonzalez  5 , Bara El Kurdi  6
Affiliations

Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis

Shrouq Khazaaleh et al. World J Transplant. .

Abstract

Background: Despite the increased use of total pancreatectomy with islet autotransplantation (TPIAT), systematic evidence of its outcomes remains limited.

Aim: To evaluate the outcomes of TPIAT.

Methods: We searched PubMed, EMBASE, and Cochrane databases from inception through March 2019 for studies on TPIAT outcomes. Data were extracted and analyzed using comprehensive meta-analysis software. The random-effects model was used for all variables. Heterogeneity was assessed using the I2 measure and Cochrane Q-statistic. Publication bias was assessed using Egger's test.

Results: Twenty-one studies published between 1980 and 2017 examining 1011 patients were included. Eighteen studies were of adults, while three studied pediatric populations. Narcotic independence was achieved in 53.5% [95% Confidence Interval (CI): 45-62, P < 0.05, I2 = 81%] of adults compared to 51.9% (95%CI: 17-85, P < 0.05, I2 = 84%) of children. Insulin-independence post-procedure was achieved in 31.8% (95%CI: 26-38, P < 0.05, I2 = 64%) of adults with considerable heterogeneity compared to 47.7% (95%CI: 20-77, P < 0.05, I2 = 82%) in children. Glycated hemoglobin (HbA1C) 12 mo post-surgery was reported in four studies with a pooled value of 6.76% (P = 0.27). Neither stratification by age of the studied population nor meta-regression analysis considering both the study publication date and the islet-cell-equivalent/kg weight explained the marked heterogeneity between studies.

Conclusion: These results indicate acceptable success for TPIAT. Future studies should evaluate the discussed measures before and after surgery for comparison.

Keywords: Islet autotransplantation; Narcotics; Pancreatectomy; Pancreatitis.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram illustrating the selection process.
Figure 2
Figure 2
Summary of event rates assessing insulin independence after total pancreatectomy with islet autotransplantation.
Figure 3
Figure 3
Summary of event rates assessing narcotic independence after total pancreatectomy with islet autotransplantation.
Figure 4
Figure 4
Pooled HgA1C means after total pancreatectomy with islet autotransplantation.
See this image and copyright information in PMC

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