Glowing islet cells intertwined with a healthy pancreas, symbolizing successful auto-transplantation.

Extended Pancreatectomy & Islet Auto-Transplantation: A Sweet Solution for Pancreatic Lesions?

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"Discover how this innovative approach offers diabetes-free survival for patients with benign or borderline/malignant pancreatic lesions."

Pancreatic surgeries, especially extended pancreatectomies (removal of a significant portion of the pancreas), often carry the risk of developing diabetes. This is because the pancreas is responsible for producing insulin, which regulates blood sugar levels. When a large part of the pancreas is removed, insulin production can be significantly reduced, leading to diabetes.

To combat this, a procedure called islet auto-transplantation (IAT) has emerged as a promising solution. IAT involves harvesting islet cells (the insulin-producing cells) from the removed portion of the pancreas and transplanting them back into the patient's liver. This helps to maintain insulin production and reduce the risk of diabetes after pancreatectomy.

A recent study investigated the long-term outcomes of IAT in patients undergoing extended distal pancreatectomy (EDP) for benign or borderline/malignant lesions of the pancreas. The results offer compelling evidence for the effectiveness of IAT in preventing diabetes and improving the quality of life for these patients.

Diabetes-Free Survival: The IAT Advantage

Glowing islet cells intertwined with a healthy pancreas, symbolizing successful auto-transplantation.

The study compared two groups of patients: those who underwent EDP with IAT and those who underwent EDP alone. The results showed a significant advantage for the IAT group in terms of diabetes-free survival. Patients who received IAT had a longer diabetes-free survival compared to those who did not.

Specifically, the study found that patients undergoing islet autotransplantation had a significantly longer diabetes-free survival than patients without islet autotransplantation (p=0.04). Furthermore, the procedure was found to be safe and successful in preventing diabetes after extended pancreatic resection for neoplasm.

IAT helps maintain insulin production after significant pancreatic removal.
The procedure reduces the chances of developing diabetes post-surgery.
IAT improves long-term diabetes-free survival rates.

This suggests that IAT is an effective strategy for preserving insulin function and preventing diabetes in patients undergoing extensive pancreatic resections. By transplanting islet cells back into the patient, doctors can help maintain glucose homeostasis and reduce the need for insulin therapy.

The Future of Pancreatic Surgery: A Brighter Outlook

Islet auto-transplantation represents a significant advancement in pancreatic surgery. By integrating this procedure with extended pancreatectomies, surgeons can not only remove diseased tissue but also minimize the risk of diabetes, leading to improved long-term outcomes and a better quality of life for patients.

While this study provides strong evidence for the benefits of IAT, further research is needed to optimize the procedure and identify the best candidates for transplantation. Factors such as islet cell quality, transplantation site, and patient characteristics may all play a role in the success of IAT.

With continued innovation and research, islet auto-transplantation has the potential to become a standard of care for patients undergoing extensive pancreatic resections, offering a sweet solution to the challenge of post-operative diabetes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/ajt.15219, Alternate LINK

Title: Diabetes‐Free Survival After Extended Distal Pancreatectomy And Islet Auto Transplantation For Benign Or Borderline/Malignant Lesions Of The Pancreas

Subject: Pharmacology (medical)

Journal: American Journal of Transplantation

Publisher: Wiley

Authors: Gianpaolo Balzano, Paola Maffi, Rita Nano, Alessia Mercalli, Raffaella Melzi, Francesca Aleotti, Francesco De Cobelli, Paola Magistretti, Marina Scavini, Antonio Secchi, Massimo Falconi, Lorenzo Piemonti

Published: 2019-01-23

Everything You Need To Know

Why does removing part of the pancreas often lead to diabetes?

Extended pancreatectomy involves removing a significant portion of the pancreas. This can lead to a reduction in insulin production, as the pancreas is responsible for producing this hormone, which regulates blood sugar levels. Consequently, patients may develop diabetes post-surgery. However, when extended pancreatectomy is paired with islet auto-transplantation, the risk of developing diabetes is significantly reduced.

What exactly happens during islet auto-transplantation (IAT)?

Islet auto-transplantation is a procedure where islet cells, which are the insulin-producing cells, are harvested from the removed portion of the pancreas. These cells are then transplanted back into the patient's liver. This process helps to maintain insulin production and reduces the risk of diabetes following an extended pancreatectomy.

What did the study discover about diabetes-free survival and islet auto-transplantation?

The study revealed that patients who underwent extended distal pancreatectomy with islet auto-transplantation experienced a significantly longer diabetes-free survival compared to those who underwent extended distal pancreatectomy alone. This suggests that islet auto-transplantation is effective in preserving insulin function and preventing diabetes in patients undergoing extensive pancreatic resections.

How does islet auto-transplantation work to prevent diabetes after pancreatic surgery?

Islet auto-transplantation works by taking the islet cells (the insulin-producing cells) from a removed portion of the pancreas and transplanting them into the patient's liver. This helps maintain insulin production, which is crucial for regulating blood sugar levels. Without enough functioning islet cells, a patient is at high risk of developing diabetes after pancreatic surgery.

What key aspects or potential complications of islet auto-transplantation were not addressed and warrant further investigation?

While the study highlights the benefits of islet auto-transplantation in preventing diabetes after extended pancreatectomy, it doesn't delve into potential complications or long-term impacts beyond diabetes-free survival. For instance, it would be beneficial to explore the impact on overall pancreatic function, digestive health, and the potential need for enzyme supplementation post-surgery. Further research into these areas would provide a more comprehensive understanding of the procedure's effects.