Abstract
Transplantation of islets isolated from autologous pancreas, commonly called islet autotransplantation (IAT), has been developed primarily for the treatment of refractory chronic pancreatitis (CP). CP is an irreversible and progressive inflammatory disease of the pancreas in which the patients often experience severe abdominal pain and malnutrition. Diabetes can result in advanced stage CP if the inflammatory response damages pancreatic islets. Multiple causes such as genetic mutations, alcohol abuse, autoimmunity, recurrent acute pancreatitis, and obstruction of the pancreatic duct are involved in the development of CP. Medication and endoscopic procedure are available for CP treatment; however, a significant portion of CP patients are eventually referred to a surgical clinic. Surgical resection of the inflamed pancreas is a treatment option if CP patients do not respond to other means of treatment although there is loss of pancreatic exocrine and endocrine functions after even a partial resection of an inflamed pancreas. IAT following total pancreatectomy (TPIAT) allows elimination of severe abdominal pain while preserving pancreatic endocrine function in a single operation. TPIAT has been applied for the treatment of benign pancreatic tumors in addition to CP. Due to the remarkable improvements in islet isolation methodologies and surgical procedures, there is a significant increase in the number of transplants and improved graft outcomes. Future directions of TPIAT include changes to current patient selection criteria and enhancing islet graft function by inhibition of the peritransplant inflammatory reaction.
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Yoshimatsu, G., Takita, M., Haque, W., Naziruddin, B., Levy, M.F. (2019). Autologous Islet Cell Transplant. In: Shah, A., Doria, C., Lim, J. (eds) Contemporary Pancreas and Small Bowel Transplantation . Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-05257-1_2002
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