Islet transplantation: outcomeMorbidity associated with intraportal islet transplantation☆
Section snippets
Materials and methods
We reviewed all islet intraportal infusions performed either for auto- or allotransplantation from 1992 to 2003. Islet autotransplantation was performed with 16 islet infusions in 16 patients. The indications for pancreatectomy were insulinoma, benign cysts, or chronic pancreatitis. Islet allotransplantation included 77 islet infusions in 51 patients. Allotransplantation procedures in type I diabetic patients were performed either as simultaneous islet and kidney transplantations (SIK), as
Results
A linear correlation was observed between tissue volume infused and rise in portal pressure (R2 = .86). However, tissue volume infused and rise in portal pressure were not correlated with occurrence of complications. No complication was recorded with the open approach in 31 infusions, while nine complications (15%) occurred with the percutaneous approach in 62 infusions (P < .03).
Complications recorded were: three perihepatic hematomas, two partial portal branch thromboses, and four
Discussion
Previous authors have reported the effect of tissue volume on portal pressure increase during islet infusion.5 We have observed the same effect in our patients, but there was no correlation between volume of tissue infused and development of complications related to the procedure. In this study, the percutaneous approach was significantly associated with increased morbidity, namely bleeding and portal thrombosis. There is a possibility that the newly described technique of islet infusion using
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This work was funded by grant 32-061873.00 from the Swiss National Science Foundation.