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Prospective characterization of incident hepatic steatosis in pediatric and adolescent patients after total pancreatectomy with islet autotransplantation |
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| Institution: | 1. Department of Radiology, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;2. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA;3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA;4. Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;5. Division of Endocrinology, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;6. Division of Pediatric General and Thoracic Surgery, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;1. Indiana University School of Medicine, United States;2. Charles Warren Fairbanks Center of Medical Ethics, Indiana University Health, United States;3. Lehman, Bucksot and Sherman Section of Pancreatobiliary Endoscopy, United States;1. Department of Surgery, Verona University Hospital Trust, Verona, Italy;2. Department of Neurosciences, Biomedicine and Movement Sciences, Verona University Hospital Trust, Verona, Italy;1. Moscow Clinical Scientific Centre, Moscow, Russia;2. Sechenov University, Moscow, Russia;3. Ilyinskaia Hospital, Moscow, Russia;4. First City Hospital Named After N.I. Pirogov, Moscow, Russia;1. Department of HPB Surgery and Transplantation, La Fe University Hospital and University of Valencia, Valencia, Spain;2. Department of General and Pancreatic Surgery, Verona Hospital Trust, University of Verona, Verona, Italy;3. Department of Nephrology and Kidney Transplantation, La Fe University Hospital and University of Valencia, Valencia, Spain;4. Department of Endocrinology, La Fe University Hospital and University of Valencia, Valencia, Spain |
| Abstract: | BackgroundHepatic steatosis has been described as a common finding in adults following total pancreatectomy with islet autotransplantation (TPIAT) but it is unknown if this occurs in children and adolescents.ObjectivesTo define the frequency of post-TPIAT hepatic steatosis in a sample of children and adolescents and to identify clinical predictors of incident steatosis post-TPIAT.MethodsIn this prospective study, consecutive participants at least 1-month post-TPIAT underwent a liver MRI with proton density fat fraction (PDFF) and blood draw at our pediatric academic medical center between April 2021 and January 2022. Comparison clinical pre-TPIAT liver MRI or ultrasound and insulin use and graft function data were extracted from the medical record. T-tests were used for the comparison of means across continuous variables between participants with and without post-TPIAT steatosis.ResultsA total of 20 participants (mean: 13 ± 4 years; 12 female) were evaluated. Mean liver PDFF at research MRI was 7.4 ± 6.2% (range: 2–25%). Seven participants (35%) had categorical hepatic steatosis (PDFF>5%) post-TPIAT, five of whom had pre-TPIAT steatosis, reflecting a 13% (2/15; 95% CI: 2–40%) incidence of post-TPIAT steatosis. Participant characteristics were not significantly different between subgroups with and without post-TPIAT steatosis. Mean PDFF at research MRI was not different between graft function subgroups (7.5% optimal/good vs. 7.3% marginal/failure; p = .96).ConclusionOur study shows a moderate prevalence but low incidence of hepatic steatosis in a small sample of children and adolescents post-TPIAT. This study raises questions about a causal relationship between TPIAT and hepatic steatosis. |
| Keywords: | Total pancreatectomy with islet autotransplantation TPIAT Proton density fat fraction Children Adolescents TPIAT"} {"#name":"keyword" "$":{"id":"pc_FZ8kbHo60a"} "$$":[{"#name":"text" "_":"Total pancreatectomy with islet autotransplantation CP"} {"#name":"keyword" "$":{"id":"pc_kGNCSs2Ksl"} "$$":[{"#name":"text" "_":"Chronic pancreatitis MRI"} {"#name":"keyword" "$":{"id":"pc_gfZyMMRpii"} "$$":[{"#name":"text" "_":"Magnetic resonance imaging PDFF"} {"#name":"keyword" "$":{"id":"pc_tAftCmkePp"} "$$":[{"#name":"text" "_":"Proton density fat fraction |
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