Total Pancreatectomy and Islet Cell Autotransplantation: Does It Have Long Lasting Benefits?

Total pancreatectomy and islet cell autotransplantation is a proven surgical option in the appropriately selected patient with excellent short-term outcomes. Islet graft function is seen in most patients, though insulin independence attenuates over time and diabetic complications appear on long-term follow-up. Narcotic independence is achieved in most patients, with continued improvement on long-term follow-up. Quality-of-life is improved across the board, although mortality remains high in this population, with new insights into potential causes. Novel strategies to improve islet engraftment, disease monitoring of resulting comorbidities, and multi-disciplinary care pathways promise to further refine outcomes with this promising therapy.