Immunologic and non-immunologic loss of islet cells upon their transplantation into the liver leads to suboptimal outcomes. Anti-inflammatory agents are used during autologous and allogeneic transplantation. The aim of this qualitative systematic literature review is to evaluate their clinical use and safety. Electronic databases Embase, PubMed, Cumulative Index for Nursing and Allied Health Literature, ClinicalTrials.gov, and EU Clinical Trials Register were searched. Of the 216 unique citations, 10 with tumor necrosis factor (TNF) blockers [etanercept (ETA) or infliximab] and 3 with both TNF blockers and an interluekin-1 receptor antagonist [anakinra (ANA)]) were included. Of these, 12 were in allogeneic and one in autologous transplant. Insulin independence with decreased islet cells and number of transfusions were reported with their use. One infection was reported in a group receiving ETA. Analysis suggested that the use of ETA ± ANA have the potential to improve outcomes in islet cell transplant.

Total pancreatectomy with autologous islet cell transplant (TPAIT) is a treatment option for patients suffering from chronic or recurrent acute pancreatitis, providing benefits of pain relief, enhanced quality of life, and prevention of brittle type 3c diabetes [1]. While surgical procedure requires extensive dissection and elevates risk of bleeding [2, 3], this operation also carries potential risk of portal venous thrombosis(0.9 to 3.4%) when impure or partially purified autologous islet preparations are infused into the portomesenteric circulation[4,5]. To mitigate the risk of thrombosis and to assist with islet engraftment by reducing Instant Blood‐Mediated Inflammatory Reaction (IBMIR), anticoagulants are often utilized intra‐ and post‐operatively [6]. Through literature review and personal communications , it is clear that different centers vary in their anticoagulation practices without any consensus guideline on the type, amount, or duration of anticoagulation, nor on the type and targets for postoperative monitoring [7]. The aim of this study is to gather information about the various anticoagulation strategies utilized by programs internationally.