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J Clin Endocrinol Metab. 2015 May;100(5):1765-70. doi: 10.1210/jc.2014-4298. Epub 2015 Mar 17.

Factors associated with islet yield and insulin independence after total pancreatectomy and islet cell autotransplantation in patients with chronic pancreatitis utilizing off-site islet isolation: Cleveland Clinic experience.

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Department of Endocrinology, Diabetes and Metabolism (P.C.J., Y.K.L., C.F., B.A.H.), and Department of General Surgery, Digestive Disease Institute (R.M.W.), Cleveland Clinic, Cleveland, Ohio, 44195; Department of Pediatrics (R.B., M.T.), Division of Immunogenetics, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Gastroenterology and Hepatology, Digestive Disease Institute (T.K.S.), and Department of Biostatistics, Quantitative Health Sciences (J.B.), Cleveland Clinic, Cleveland, Ohio, 44195.



Total pancreatectomy (TP) with islet cell autotransplantation (IAT) can reduce or prevent diabetes by preserving beta cell function and is normally performed with on-site isolation laboratory facilities.


We examined factors associated with islet yield and metabolic outcomes in patients with chronic pancreatitis undergoing TP-IAT. We report our experience of TP-IAT with an off-site islet isolation laboratory.


Data (August 2008 to February 2014) were obtained from a TP-IAT database which included information from medical records, clinic visits, questionnaires, and follow-up telephone calls. Each patient was assessed with pre- and postoperative 5-hour mixed-meal tolerance tests for metabolic measurements and with serial glycosylated hemoglobin (HbA1c) determinations.


Thirty-six patients with a mean age of 38 years (range, 16-72 y) underwent TP-IAT for different etiologies. At a median follow-up time of 28 months (range, 3-66 mo), 12 patients were insulin independent and 24 patients were on at least one insulin injection a day. Postoperatively, C-peptide levels ≥0.3 ng/mL were present in 23/33 (70%) of the patients, with a median fasting C-peptide value of 0.8 ng/mL (range, <0.2-1.5 ng/mL). Those who were insulin independent were more likely to be female (P = .012), have normal morphology on pre-operative pancreatic imaging (P = .011), and have significantly higher median islet yield (6845 islet equivalent numbers [IEQ]/kg, n = 12 vs 3333 IEQ/kg, n = 24; P < .001).


IAT after TP performed in our facility with an off-site islet isolation laboratory shows islet yield and rates of insulin independence that are comparable to other large centers with on-site laboratories.

[Indexed for MEDLINE]

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