|
1
|
Berger MG, Majumder K, Hodges JS, Bellin MD, Schwarzenberg SJ, Gupta S, Dunn TB, Beilman GJ, Pruett TL, Freeman ML, Wilhelm JJ, Sutherland DER, Chinnakotla S. Microbial contamination of transplant solutions during pancreatic islet autotransplants is not associated with clinical infection in a pediatric population. Pancreatology 2016; 16:555-62. [PMID: 27134135 DOI: 10.1016/j.pan.2016.03.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/08/2016] [Accepted: 03/28/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Total pancreatectomy and islet autotransplant (TP-IAT) is a potential treatment for children with severe refractory chronic pancreatitis. Cultures from the resected pancreas and final islet preparation are frequently positive for microbes. It is unknown whether positive cultures are associated with adverse outcomes in pediatric patients. METHODS We reviewed the medical records of children (n = 86) who underwent TP-IAT from May 2006-March 2015 with emphasis on demographics, previous pancreatic interventions, culture results, islet yield, hospital days, posttransplant islet function, and posttransplant infections. We compared outcomes in patients with positive (n = 57) and negative (n = 29) cultures. RESULTS Patients with positive cultures had higher rates of previous pancreas surgery (P = 0.007) and endoscopic retrograde cholangiopancreatography (P < 0.0001). Positive cultures were not associated with posttransplant infections (P = 1.00) or prolonged hospital length of stay (P = 0.29). Patients with positive final islet preparation culture showed increased rates of graft failure at 2 years posttransplant (P = 0.041), but not when adjusted for islet mass transplanted (P = 0.39). CONCLUSIONS Positive cultures during pediatric TP-IATs do not increase the risk of posttransplant infections or prolong hospital length of stay. Endocrine function depends on islet mass transplanted.
Collapse
Affiliation(s)
- Megan G Berger
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Kaustav Majumder
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA
| | - James S Hodges
- Department of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Melena D Bellin
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA; Schulze Diabetes Institute, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Sameer Gupta
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ty B Dunn
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Gregory J Beilman
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Timothy L Pruett
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Martin L Freeman
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Joshua J Wilhelm
- Schulze Diabetes Institute, University of Minnesota Medical School, Minneapolis, MN, USA
| | - David E R Sutherland
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA; Schulze Diabetes Institute, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Srinath Chinnakotla
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|