Abstract:
Objective: To describe management strategies that contributed to optimal outcomes in pediatric recipients of a total pancreatectomy with islet autotransplantation (TPIAT). Research Design and Methods: We provide a comprehensive report of the approach to endocrine management of the pediatric TPIAT recipient from initial evaluation through the first 4 years postsurgery. We performed a retrospective review of the endocrine outcomes of TPIAT recipients to describe the impact of this approach on post-TPIAT glycemic management. Results: Outcome data from 86 TPIAT recipients were reviewed. At 12 months post-TPIAT (n = 82), the median HbA1C was 6.0% (25-75th percentile 5.6-6.7), at 18 months (n = 56) HbA1C was 6.4% (5.6-7.5), at 2 years (n = 46) HbA1C was 6.4% (5.6-7.4), at 3 years (n = 31) HbA1C was 6.5% (5.5-8.1), and at 4 years (n = 16) HbA1C was 7.2% (6.2-8.3). Conclusions: Pediatric patients at our institution have favorable endocrine outcomes as evidenced by median HbA1C under the goal of 6.5% through the initial 3 years by following our modified management protocols.
摘要:
目的:描述有助于小儿全胰腺切除术伴胰岛自体移植(TPIAT)的最佳结局的管理策略。
方法:我们提供了从最初评估到手术后最初4年的儿科TPIAT受体内分泌管理方法的综合报告。我们对TPIAT受者的内分泌结局进行了回顾性审查,以描述该方法对TPIAT后血糖管理的影响。
结果:对86名TPIAT接受者的结果数据进行了综述。在TPIAT(n=82)后12个月,HbA1C中位数为6.0%(25-75百分位数5.6-6.7),18个月时(n=56)HbA1C为6.4%(5.6-7.5),在2年(n=46)HbA1C为6.4%(5.6-7.4),3年时(n=31)HbA1C为6.5%(5.5-8.1),4年时(n=16)HbA1C为7.2%(6.2-8.3).
结论:通过遵循我们修改的管理方案,我们机构的儿科患者在最初三年的平均HbA1C在6.5%的目标下具有良好的内分泌结局。