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BACKGROUND: Total pancreatectomy with islet autotransplantation (TPIAT) is utilized for management of intractable pain due to chronic pancreatitis. Patient selection is a major factor in improving clinical outcomes. Identifying characteristics of the population undergoing TPIAT is an important step in defining the patient selection process.

METHODS: Inpatient and outpatient data were reviewed retrospectively utilizing a prospectively collected database (TPIAT patients) and a hospital administrative database (TPIAT patients and controls). Data from 70 TPIAT patients were compared to a random sampling of 140 controls (with pancreatitis, total population 1,889). For all patients, data were captured from January 2008 forward, allowing for 14 months prior to the first TPIAT patient in March 2009. Patients were considered to have a particular co-morbidity if they had 1inpatient ICD-9 or ≥ 2 outpatient ICD-9s recorded in the data. ICD-9 codes captured pre and post- transplant were not distinguished for transplant patients. Non-MUSC data was not available for this analysis. Fisher’s exact test was used to determine differences between groups, significance determined at 0.05.

RESULTS: TPIAT patients were more likely to be women (p<0.001), younger (p<0.005) and more frequently white (p<0.003) than controls. A higher proportion of TPIAT patients had drug dependence (p<0.0001) and depression (p<0.0001), compared to controls. Conversely controls more likely had hypertension (p=0.0050) and renal failure (p=0.0031).

CONCLUSIONS: Patients undergoing TPIAT differ from the overall population of patients with chronic pancreatitis. Depression and narcotic dependence are important considerations in the selection of candidates for the procedure and are disorders which need targeted postoperative therapy.