Impact of microbial contamination of the islet product during total pancreatectomy with islet autotransplantation.
Adolescent
Adult
Aged
Anti-Bacterial Agents
/ therapeutic use
Anti-Inflammatory Agents, Non-Steroidal
/ adverse effects
Bacterial Infections
/ chemically induced
C-Peptide
/ blood
Etanercept
/ adverse effects
Female
Glycated Hemoglobin
/ analysis
Humans
Hypoglycemic Agents
/ therapeutic use
Immunosuppressive Agents
/ adverse effects
Insulin
/ therapeutic use
Interleukin 1 Receptor Antagonist Protein
/ adverse effects
Interleukin-1beta
/ antagonists & inhibitors
Islets of Langerhans
/ microbiology
Islets of Langerhans Transplantation
/ adverse effects
Male
Middle Aged
Pancreatectomy
/ adverse effects
Pancreatitis, Chronic
/ blood
Retrospective Studies
Risk Factors
Transplantation, Autologous
/ adverse effects
Treatment Outcome
Tumor Necrosis Factor-alpha
/ antagonists & inhibitors
Young Adult
bacterial contamination
complication
fibrosis
immunosuppression
islet transplantation
Journal
Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
02
10
2019
revised:
22
11
2019
accepted:
08
01
2020
pubmed:
17
1
2020
medline:
16
2
2021
entrez:
17
1
2020
Statut:
ppublish
Résumé
The combined use of interleukin-1β and tumor necrosis factor-α blockers in the peritransplant period has improved outcomes of total pancreatectomy with islet autotransplantation (TPIAT). However, these drugs may suppress the immune system, resulting in severe infection. We retrospectively investigated the impact of microbial-contaminated islet product on posttransplant complications and metabolic outcomes of TPIAT patients receiving the IL-1β and TNF-blockade treatment at our center. Among 108 TPIAT patients, 37 patients (34%) received contaminated products. Preoperative stent treatment and fibrosis score were independent risk factors for the contamination. There were no significant differences between the contaminated and noncontaminated product groups in posttransplant infectious complication rate, length of hospitalization, or readmission rate. However, islet equivalents (P < .0001) and insulin independence rate (P = .036) at 6 months were significantly lower for patients receiving contaminated product. These results suggest that combined anti-inflammatory drug use is safe and well tolerated in TPIAT patients who receive contaminated islet product and does not increase the rate of infectious complications; however, contaminated islet product is associated with poor metabolic outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
The combined use of interleukin-1β and tumor necrosis factor-α blockers in the peritransplant period has improved outcomes of total pancreatectomy with islet autotransplantation (TPIAT). However, these drugs may suppress the immune system, resulting in severe infection.
METHODS
METHODS
We retrospectively investigated the impact of microbial-contaminated islet product on posttransplant complications and metabolic outcomes of TPIAT patients receiving the IL-1β and TNF-blockade treatment at our center.
RESULTS
RESULTS
Among 108 TPIAT patients, 37 patients (34%) received contaminated products. Preoperative stent treatment and fibrosis score were independent risk factors for the contamination. There were no significant differences between the contaminated and noncontaminated product groups in posttransplant infectious complication rate, length of hospitalization, or readmission rate. However, islet equivalents (P < .0001) and insulin independence rate (P = .036) at 6 months were significantly lower for patients receiving contaminated product.
CONCLUSIONS
CONCLUSIONS
These results suggest that combined anti-inflammatory drug use is safe and well tolerated in TPIAT patients who receive contaminated islet product and does not increase the rate of infectious complications; however, contaminated islet product is associated with poor metabolic outcomes.
Substances chimiques
Anti-Bacterial Agents
0
Anti-Inflammatory Agents, Non-Steroidal
0
C-Peptide
0
Glycated Hemoglobin A
0
Hypoglycemic Agents
0
Immunosuppressive Agents
0
Insulin
0
Interleukin 1 Receptor Antagonist Protein
0
Interleukin-1beta
0
Tumor Necrosis Factor-alpha
0
hemoglobin A1c protein, human
0
Etanercept
OP401G7OJC
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
211-218Informations de copyright
© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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