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Updated: Sep 6, 2025
Isolation of Human Islets from Partially Pancreatectomized Patients
Published on: July 30, 2011
Is There a Benefit From Islet Autotransplantation in Patients With Type 1 Diabetes Mellitus Undergoing Total
Insights
Total pancreatectomy with islet autotransplantation (TPIAT) significantly reduced abdominal pain and opioid dependence in children with chronic pancreatitis and type 1 diabetes mellitus (T1DM). This procedure improved quality of life and allowed a slight reduction in insulin dosage for one patient.
Area of Science:
- Endocrinology
- Gastroenterology
- Surgical Oncology
Background:
- Children with chronic pancreatitis (CP) suffer debilitating abdominal pain, leading to opioid dependence and reduced quality of life.
- Total pancreatectomy with islet autotransplantation (TPIAT) is a surgical option for refractory CP, but outcomes in patients with type 1 diabetes mellitus (T1DM) are not well-established.
- T1DM is characterized by the loss of insulin-producing beta cells.
Purpose of the Study:
- To evaluate the clinical and laboratory outcomes of TPIAT in pediatric patients with CP and long-standing T1DM.
- To assess the impact of TPIAT on pain, opioid use, quality of life, and insulin requirements in this specific patient population.
Main Methods:
- TPIAT was performed in two pediatric patients with CP and T1DM (diagnosed at least 6 years prior).
- Clinical and laboratory outcomes were assessed before and after the surgical procedure.
- In vitro analysis of islet isolates from T1DM patients was conducted to evaluate residual alpha and beta cell function.
Main Results:
- Both patients experienced significant reduction in abdominal pain post-TPIAT, enabling cessation of opioid medications.
- Patients returned to full-time school attendance, indicating improved quality of life.
- One patient demonstrated a slight reduction in daily insulin dosage at 12 months post-TPIAT.
- In vitro studies showed residual alpha and beta cells in T1DM islets secreted glucagon and insulin, respectively.
Conclusions:
- TPIAT is a viable surgical option for managing severe CP in pediatric patients with T1DM, effectively alleviating pain and improving quality of life.
- The procedure can lead to reduced opioid dependence and potentially a decrease in insulin requirements.
- Residual endocrine function in T1DM islets may contribute to post-TPIAT outcomes.
Abstract:
Children with acute recurrent and chronic pancreatitis (CP) experience abdominal pain that leads to hospitalizations, opioid dependence, and poor quality of life. Total pancreatectomy with islet autotransplantation (TPIAT) is offered as a surgical option in management of debilitating pancreatitis that fails medical and endoscopic therapy to reduce or eliminate pain. Given that patients with type 1 diabetes mellitus (T1DM) lack insulin-producing β cells, the outcomes from autotransplanting islet isolates back into total pancreatectomy patients with T1DM are not fully known.We performed TPIAT in 2 CP patients who also had a diagnosis of T1DM for at least 6 years before the operation and evaluated the clinical and laboratory outcomes before and after the operation. Postoperatively both patients' abdominal pain had significantly subsided, they were weaned off opioid medications, and they were able to return to full-time school attendance. In addition, total daily dose of insulin in 1 patient was able to be slightly reduced at 12 months post-TPIAT. We observed in vitro that residual α cells and β cells in T1DM islets were able to secrete a small amount of glucagon and insulin, respectively.
