Progress in individualizing autologous islet isolation techniques for pediatric islet autotransplantation after total pancreatectomy in children for chronic pancreatitis.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Joshua J WilhelmSrinath Chinnakotla

Abstract

Total pancreatectomy with islet autotransplantation is performed to treat chronic pancreatitis in children. Successful islet isolation must address the challenges of severe pancreatic fibrosis and young donor age. We have progressively introduced modifications to optimize enzymatic and mechanical dissociation of the pancreas during islet isolation. We evaluated 2 islet isolation metrics in 138 children-digest islet equivalents per gram pancreas tissue (IEQ/g) and digest IEQ per kilogram body weight (IEQ/kg), using multiple regression to adjust for key disease and patient features. Islet yield at digest had an average 4569 (standard deviation 2949) islet equivalent (IEQ)/g and 4946 (4009) IEQ/kg, with 59.1% embedded in exocrine tissue. Cases with very low yield (<2000 IEQ/g or IEQ/kg) have decreased substantially over time, 6.8% and 9.1%, respectively, in the most recent tertile of time compared to 19.2% and 23.4% in the middle and 34.1% and 36.4% in the oldest tertile. IEQ/g and IEQ/kg adjusted for patient and disease factors improved in consistency and yield in the modern era. Minimal mechanical disruption during digestion, warm enzymatic digestion using enzyme collagenase:NP activity ratio < 10:1, coupled with extended disten...Continue Reading

References

Jan 1, 1996·Journal of Pediatric Surgery·D C WahoffD E Sutherland
Aug 16, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A N BalamuruganRita Bottino
Jun 20, 2006·Diabetologia·A N BalamuruganR Bottino
Jul 9, 2008·Journal of Pediatric Gastroenterology and Nutrition·Melena D BellinDavid E R Sutherland
Mar 25, 2014·Journal of the American College of Surgeons·Srinath ChinnakotlaTimothy L Pruett
Jan 4, 2015·The Journal of Pediatrics·Sarah Jane SchwarzenbergAliye Uc
Aug 16, 2015·Current Diabetes Reports·Melena D BellinSrinath Chinnakotla
Feb 24, 2017·Journal of Pediatric Gastroenterology and Nutrition·Melena D BellinSrinath Chinnakotla
Mar 22, 2019·Journal of Pediatric Gastroenterology and Nutrition·Sarah J SchwarzenbergDhiraj Yadav
Oct 1, 2019·Journal of Pediatric Gastroenterology and Nutrition·Emily R PeritoAliye Uc

❮ Previous
Next ❯

Citations

Feb 19, 2021·Molecular Imaging and Biology : MIB : the Official Publication of the Academy of Molecular Imaging·Zuzana HladíkováFrantišek Saudek
Jun 27, 2021·Current Opinion in Gastroenterology·Dhiraj YadavDarwin L Conwell

❮ Previous
Next ❯

Related Concepts

Related Feeds

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.