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Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis

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...

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Autores principales: Khazaaleh, Shrouq, Babar, Sumbal, Alomari, Mohammad, Imam, Zaid, Chadalavada, Pravallika, Gonzalez, Adalberto Jose, Kurdi, Bara El
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850868/
https://www.ncbi.nlm.nih.gov/pubmed/36687559
http://dx.doi.org/10.5500/wjt.v13.i1.10
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author Khazaaleh, Shrouq
Babar, Sumbal
Alomari, Mohammad
Imam, Zaid
Chadalavada, Pravallika
Gonzalez, Adalberto Jose
Kurdi, Bara El
author_facet Khazaaleh, Shrouq
Babar, Sumbal
Alomari, Mohammad
Imam, Zaid
Chadalavada, Pravallika
Gonzalez, Adalberto Jose
Kurdi, Bara El
author_sort Khazaaleh, Shrouq
collection PubMed
description 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 I(2) 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, I(2) = 81%] of adults compared to 51.9% (95%CI: 17-85, P < 0.05, I(2) = 84%) of children. Insulin-independence post-procedure was achieved in 31.8% (95%CI: 26-38, P < 0.05, I(2) = 64%) of adults with considerable heterogeneity compared to 47.7% (95%CI: 20-77, P < 0.05, I(2) = 82%) in children. Glycated hemoglobin (HbA(1C)) 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.
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spelling pubmed-98508682023-01-20 Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis Khazaaleh, Shrouq Babar, Sumbal Alomari, Mohammad Imam, Zaid Chadalavada, Pravallika Gonzalez, Adalberto Jose Kurdi, Bara El World J Transplant Meta-Analysis 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 I(2) 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, I(2) = 81%] of adults compared to 51.9% (95%CI: 17-85, P < 0.05, I(2) = 84%) of children. Insulin-independence post-procedure was achieved in 31.8% (95%CI: 26-38, P < 0.05, I(2) = 64%) of adults with considerable heterogeneity compared to 47.7% (95%CI: 20-77, P < 0.05, I(2) = 82%) in children. Glycated hemoglobin (HbA(1C)) 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. Baishideng Publishing Group Inc 2023-01-18 2023-01-18 /pmc/articles/PMC9850868/ /pubmed/36687559 http://dx.doi.org/10.5500/wjt.v13.i1.10 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Meta-Analysis
Khazaaleh, Shrouq
Babar, Sumbal
Alomari, Mohammad
Imam, Zaid
Chadalavada, Pravallika
Gonzalez, Adalberto Jose
Kurdi, Bara El
Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis
title Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis
title_full Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis
title_fullStr Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis
title_full_unstemmed Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis
title_short Outcomes of total pancreatectomy with islet autotransplantation: A systematic review and meta-analysis
title_sort outcomes of total pancreatectomy with islet autotransplantation: a systematic review and meta-analysis
topic Meta-Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850868/
https://www.ncbi.nlm.nih.gov/pubmed/36687559
http://dx.doi.org/10.5500/wjt.v13.i1.10
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