Portal venous pressure changes after sequential clinical islet transplantation

Transplantation. 2002 Oct 15;74(7):913-5. doi: 10.1097/00007890-200210150-00002.


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.

MeSH terms

  • Humans
  • Injections, Intravenous
  • Islets of Langerhans Transplantation* / adverse effects
  • Islets of Langerhans Transplantation* / methods
  • Portal Vein / physiopathology*
  • Postoperative Period
  • Venous Pressure*
  • Venous Thrombosis / etiology