Abstract | OBJECTIVES: MATERIALS AND METHODS: We reviewed medical records for 24 patients 18 years old or younger who underwent pancreatectomy with islet autotransplantation at the University of Minnesota from July 1989 through June 2006. Patients and/or their parents were invited to participate in a follow-up telephone survey. Primary outcome measures were narcotics and insulin use at follow-up. We compared outcomes in patients undergoing surgery as preadolescents (<13 years old) versus adolescents. RESULTS: Follow-up information was available on 18 of 24 patients. All of the patients required narcotics before surgery. Of the 18, only 7 (39%) were still taking narcotics at the time of the survey. At 1 year posttransplant, 78% of patients had islet graft function with full function ( insulin independent) in 56% and partial function (once-daily insulin use only) in 22%. By Cox regression analysis, important predictors of insulin independence were islet yield >2000 islet equivalents per kilogram and lack of prior pancreatic surgery (P = 0.011). Preadolescents were less likely to require chronic narcotic therapy at follow-up (P = 0.05) and were more likely to maintain graft function (P = 0.02) compared with adolescents. CONCLUSIONS:
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Authors | Melena D Bellin, Annelisa M Carlson, Takashi Kobayashi, Angelika C Gruessner, Bernhard J Hering, Antoinette Moran, David E R Sutherland |
Journal | Journal of pediatric gastroenterology and nutrition
(J Pediatr Gastroenterol Nutr)
Vol. 47
Issue 1
Pg. 37-44
(Jul 2008)
ISSN: 1536-4801 [Electronic] United States |
PMID | 18607267
(Publication Type: Journal Article)
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Chemical References |
- Hypoglycemic Agents
- Insulin
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Topics |
- Adolescent
- Child
- Child, Preschool
- Diabetes Mellitus, Type 1
(etiology, pathology, prevention & control)
- Female
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Insulin
(therapeutic use)
- Islets of Langerhans Transplantation
- Male
- Pain, Intractable
(therapy)
- Pancreatectomy
(methods)
- Pancreatitis, Chronic
(surgery, therapy)
- Severity of Illness Index
- Survival Rate
- Transplantation, Autologous
- Treatment Outcome
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