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Positive sterility cultures of transplant solutions during pancreatic islet autotransplantation are associated infrequently with clinical infection.

Abstract：

BACKGROUND:Chronic pancreatitis is a painful and often debilitating disease. Total pancreatectomy with intra-portal islet autotransplantation (TP-IAT) is a treatment option that allows for pain relief and preservation of beta-cell mass, thereby minimizing the complication of diabetes mellitus. Cultures of harvested islets are often positive for bacteria, possibly due to frequent procedures prior to TP-IAT, such as endoscopic retrograde cholangiopancreatography (ERCP), stenting, or other operative drainage procedures. It is unclear if these positive cultures contribute to post-operative infections. HYPOTHESIS:We hypothesized that positive cultures of transplant solutions will not be associated with increased infection risk. METHODS:We reviewed retrospectively the sterility cultures from both the pancreas preservation solution used to transport the pancreas and the final islet preparation for intra-portal infusion of patients who underwent TP-IAT between April 2006 and November 2012. Two hundred fifty-one patients underwent total, near-total, or completion pancreatectomy with IAT and had complete sterility cultures. All patients received prophylactic peri-operative antibiotics. Patients with positive pancreas preservation solution or islet sterility cultures received further antibiotics for 5-7 d. Patients' medical records were reviewed for post-operative infections and causative organisms. RESULTS:Of the 251 patients included, 151 (61%) had one or more positive bacterial cultures from the pancreas preservation solution or final islet product. Seventy-three of the 251 patients (29%) had an infectious complication. Thirty-four of the 73 (22%) patients with a post-operative infectious complication also had positive cultures. Only seven of 151 patients with positive cultures (4.7%) had an infectious complication caused by the same organism as that isolated from their pancreas or islet cell preparation. CONCLUSIONS:In autologous islet preparations, isolation solutions frequently have positive cultures, but this finding is associated infrequently with clinical infection.

journal_name

Surg Infect (Larchmt)

journal_title

Surgical infections

authors

Colling KP,Blondet JJ,Balamurugan AN,Wilhelm JJ,Dunn T,Pruett TL,Sutherland DE,Chinnakotla S,Bellin M,Beilman GJ

doi

10.1089/sur.2013.224

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

115-23

issue

eissn

1096-2964

issn

1557-8674

journal_volume

pub_type

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Positive sterility cultures of transplant solutions during pancreatic islet autotransplantation are associated infrequently with clinical infection.