Abstract:
BACKGROUND:Sequential pancreatic islet transplantation via the portal vein has led to insulin independence in patients with type 1 diabetes. Complications associated with the injection of islets into the portal vein have been reported; therefore, in this study we sought to further characterize changes in portal venous pressure associated with islet infusion. METHODS:Pre- and posttransplant portal venous pressures were recorded in 50 consecutive transplant procedures in 26 patients receiving highly purified, heparinized allogeneic islet preparations via a radiologically placed portal venous cannula. Doppler ultrasound scans of the portal vein were completed within 24 hr of transplantation. RESULTS:Posttransplant portal vein pressures rose significantly with sequential transplantation (12.4 mm Hg vs. 17.3 mm Hg, P <0.05). Portal pressure change correlated significantly with islet packed cell volume (r =0.66, P <0.001) and also with the number of islets transplanted ( r=0.49, P <0.001). Segmental portal vein thrombosis was radiologically detected after two procedures (4%). CONCLUSION:Multiple sequential islet transplants can be safely performed via the portal vein, provided that care is taken with islet purification and attention is paid to portal venous monitoring.
journal_name
Transplantationjournal_title
Transplantationauthors
Casey JJ,Lakey JR,Ryan EA,Paty BW,Owen R,O'Kelly K,Nanji S,Rajotte RV,Korbutt GS,Bigam D,Kneteman NN,Shapiro AMdoi
10.1097/00007890-200210150-00002subject
Has Abstractpub_date
2002-10-15 00:00:00pages
913-5issue
7eissn
0041-1337issn
1534-6080journal_volume
74pub_type
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