Systematic review and meta-analysis of health-related quality of life outcomes after total pancreatectomy and islet auto-transplantation.

OBJECTIVE

To systematically review the literature on quality of life (QOL) after islet transplantation following total pancreatectomy in chronic pancreatitis (CP).

BACKGROUND

Total pancreatectomy and islet auto-transplantation (TPIAT) aims to relieve pain while preserving β-cell function in CP patients.

METHODS

A systematic search of Medline, PubMed, EMBASE was performed according to PRISMA framework to identify studies reporting on QOL after TPIAT for CP. Random effects meta-analyses were performed to pool results on change in physical component summary (PCS) and mental component summary (MCS) QOL scores.

RESULTS

Twenty-nine studies performed between 2011 and 2025 with a total of 4075 patients were included of which 24.8% were paediatric patients. 19 studies used the RAND SF36 QOL instrument, the most used instrument. The QOL surveys were performed from 1 month to more than 10 years post-TPIAT. Response rates varied from 14% to 100%. PCS scores were significantly higher at 1-year post-TPIAT (pooled estimate 10.36, 95% CI 7.33 to 13.4, p = <0.001) and at longest follow up (pooled estimate 16.07, 95% CI 5.80 to 26.34, p = 0.002). MCS scores were also significantly higher at 1-year post-TPIAT (pooled estimate 5.54, 95% CI 3.30 to 7.78, p = <0.001) and at longest follow up (pooled estimate 13.26, 95% CI 3.67 to 22.85, p = 0.007). Improvements in QOL appear to persist beyond 10 years.

CONCLUSION

TPIAT offers both short-term and long-term improvements in physical and mental components of QOL. However, development of TPIAT specific QOL instrument is warranted to capture TPIAT specific outcomes which determine QOL.