Transaminitis after pancreatic islet transplantation

J Am Coll Surg. 2005 Mar;200(3):353-61. doi: 10.1016/j.jamcollsurg.2004.10.021.


Background: An asymptomatic, self-limited transaminitis uniformly follows pancreatic islet transplantation (PIT) performed through portal vein (PV) infusion. The underlying cause and significance of this transaminitis is unclear.

Study design: Records of all patients with insulin-dependent diabetes mellitus who had undergone PIT at our institution were reviewed. All PITs were performed in conjunction with a remote pancreatic islet isolation center and done through percutaneous transhepatic PV infusion. Alanine aminotransferase (ALT) levels, serum glucose concentrations, insulin requirements, and color-flow Doppler ultrasonography examinations of the right upper quadrant were assessed before and after PIT.

Results: Eleven patients have undergone a total of 26 PITs. An elevated ALT level occurred in all 11 patients (100%) after the first PIT, with the median post-PIT peak ALT level reaching 187 IU/L. Transaminitis was less frequent and less marked after the second PIT. A negative correlation between viability of the pancreatic islets transplanted (r = -0.44, p = 0.03) and a positive correlation between the ratio of maximum to initial PV pressure (r = 0.41, p = 0.04) were seen with the subsequent ALT peak. Color-flow Doppler ultrasonography examinations showed no occurrences of PV thrombosis or intrahepatic hematoma. Finally, the degree of transaminitis did not correlate with post-PIT insulin requirements, indicating that post-PIT transaminitis cannot be used to measure allograft rejection or function.

Conclusions: Transaminitis after PIT is common and self-limited. Post-PIT transaminitis does not signal acute rejection or serious procedure-related complications such as PV thrombosis or intrahepatic hematoma.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alanine Transaminase / blood*
  • Aspartate Aminotransferases / blood
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Budd-Chiari Syndrome / diagnostic imaging
  • Budd-Chiari Syndrome / enzymology
  • Budd-Chiari Syndrome / etiology
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / enzymology
  • Diabetes Mellitus, Type 1 / surgery*
  • Female
  • Graft Rejection / diagnostic imaging
  • Graft Rejection / enzymology
  • Graft Rejection / etiology
  • Humans
  • Islets of Langerhans / metabolism*
  • Islets of Langerhans Transplantation / adverse effects*
  • Liver / diagnostic imaging
  • Liver / metabolism
  • Male
  • Middle Aged
  • Portal Pressure
  • Portal Vein / diagnostic imaging
  • Portal Vein / physiopathology
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / enzymology*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Ultrasonography, Doppler, Color


  • Biomarkers
  • Blood Glucose
  • Aspartate Aminotransferases
  • Alanine Transaminase