Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis.
World J Transplant
; 13(1): 10-24, 2023 Jan 18.
Article
em En
| MEDLINE
| ID: mdl-36687559
ABSTRACT
BACKGROUND:
Despite the increased use of total pancreatectomy with islet autotransplantation (TPIAT), systematic evidence of its outcomes remains limited.AIM:
To evaluate the outcomes of TPIAT.METHODS:
We searched PubMed, EMBASE, and Cochrane databases from inception through March 2019 for studies on TPIAT outcomes. Data were extracted and analyzed using comprehensive meta-analysis software. The random-effects model was used for all variables. Heterogeneity was assessed using the I2 measure and Cochrane Q-statistic. Publication bias was assessed using Egger's test.RESULTS:
Twenty-one studies published between 1980 and 2017 examining 1011 patients were included. Eighteen studies were of adults, while three studied pediatric populations. Narcotic independence was achieved in 53.5% [95% Confidence Interval (CI) 45-62, P < 0.05, I2 = 81%] of adults compared to 51.9% (95%CI 17-85, P < 0.05, I2 = 84%) of children. Insulin-independence post-procedure was achieved in 31.8% (95%CI 26-38, P < 0.05, I2 = 64%) of adults with considerable heterogeneity compared to 47.7% (95%CI 20-77, P < 0.05, I2 = 82%) in children. Glycated hemoglobin (HbA1C) 12 mo post-surgery was reported in four studies with a pooled value of 6.76% (P = 0.27). Neither stratification by age of the studied population nor meta-regression analysis considering both the study publication date and the islet-cell-equivalent/kg weight explained the marked heterogeneity between studies.CONCLUSION:
These results indicate acceptable success for TPIAT. Future studies should evaluate the discussed measures before and after surgery for comparison.
Texto completo:
1
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
/
Systematic_reviews
Idioma:
En
Revista:
World J Transplant
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos