Use of hyperglycemic clamp to assess pancreatectomy and islet cell autotransplant in patient with heterotaxy syndrome and dorsal pancreas agenesis leading to chronic pancreatitis

Diedert L De Paep, Pieter Gillard, Zhidong Ling, Hilde Verbeke, Geert Maleux, Vincent Vandecaveye, Yves Debaveye, Bart Keymeulen, Schalk van der Merwe, Daniel Pipeleers, Jacques Pirenne, Hannah van Malenstein, Daniel Jacobs-Tulleneers-Thevissen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Patients with heterotaxy syndrome (HS) can present with an associated complete dorsal pancreas agenesis (DPA). They are considered to be at increased risk for developing diabetes due to a reduced functional beta cell mass (FBM) as well as for chronic pancreatitis leading to unmanageable pain. We report the case of a young female with chronic pancreatitis due to HS and associated DPA. She presented with a severe persisting upper abdominal pain refractory to non-surgical treatment. Unlike in previously reported cases, she had a high FBM (i.e. 150% of normoglycemic controls) as determined by hyperglycemic clamp. She underwent a total pancreatectomy followed within 24 hours by an intraportal autologous islet cell transplant containing 4 x 106 beta cells (4,700 IEQ)/kg bodyweight. After surgery, the pain resolved, eliminating the need for analgesics. The intraportal implant established an adequate FBM (72% of controls at posttransplant month 2) achieving glycemic control without need for insulin administration. A hyperglycemic clamp can assess utility and efficacy of an intraportal islet cell autotransplant following total pancreatectomy in patients with HS and complete DPA.

Original languageEnglish
Pages (from-to)3662-3666
Number of pages5
JournalAmerican Journal of Transplantation
Volume20
Issue number12
Early online date2020
DOIs
Publication statusPublished - Dec 2020

Bibliographical note

© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.

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