For a study, researchers sought to develop if islet autotransplantation (IAT) improves the quality of life (QoL) in individuals who have had complete pancreatectomy and islet autotransplantation on its own (TP-IAT). TP-IAT was increasingly being used for persistent chronic pancreatitis. However, uncertainty existed over how IAT will affect QoL and long-term islet function. Therefore, patients who underwent TP-IAT at their facility and had at least 1 short form-36 measure of the quality of life were included. C-peptide was used to categorize patients as either insulin-independent or dependent and having either functioning or failing islet transplants. In order to account for the time after transplant and within-person correlation, a linear mixed model was used to assess the relationships between insulin use and islet graft function and QoL measures. A total of 2,161 QoL surveys were completed by 564 patients (median (interquartile range) age: 34 (20, 45) years, 71% female) among 817 recipients of islet autografts. About 42.7% of the time and 17.3% of the time following TP-IAT, respectively, QoL data were available. Patients who were insulin-independent had a better quality of life in 7 out of the 8 subscale domains, as well as for the Physical Component Summary and Mental Component Summary scores (all P<0.05). Insulin-dependent individuals had a Physical Component Summary that was 2.91 (SE=0.57) higher (P<0.001). There were no differences in quality of life between people with and without functioning grafts, but islet graft failure was uncommon (15% of patients). With islet transplant failure, however, glycosylated hemoglobin was significantly higher. Insulin independence greatly improved quality of life, and an islet graft that was working reduced glycosylated hemoglobin. The findings supported providing IAT as an alternative to undergoing a complete pancreatectomy and administering exogenous insulin.
Source: journals.lww.com/annalsofsurgery/Abstract/2022/09000/Intraportal_Islet_Autotransplantation.4.aspx
