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Influence of Liver Histopathology on Transaminitis Following Total Pancreatectomy and Autologous Islet Transplantation.
MedLine Citation:
PMID:  22688185     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: In type 1 diabetics undergoing allogenic islet transplants, transaminitis and portal vein thrombosis (PVT) after transhepatic portal infusion of islets may be related to infusion pressure and the purity of islets. Complications of intraoperative portal infusion of islets in patients with chronic pancreatitis undergoing a total pancreatectomy (TP) and autologous islet transplant (AIT) and the relationship to liver histopathology have not been examined. AIM: The purpose of this study was to examine complications of intraportal infusion of autologous islets after TP. METHODS: Data on 26 TP-AIT patients were analyzed. RESULTS: Infusion of islets [mean 304,473 ± 314,557 islet equivalents, median volume 300 mL (50-600)] resulted in mean postinfusion PV pressure of 9.15 ± 10.09 cmH(2)O which correlated with infused islets equivalents (r (2) = 33.6, P = 0.002) and volume (r (2) = 30.4, P = 0.005). Of 23 patients undergoing liver biopsy, 8 (35 %) were normal, 10 (43 %) had steatosis, and 5 (22 %) periportal fibrosis. Peak alanine aminotransferase (ALT; median 1 day after infusion) differed among the three histologic groups (P = 0.025). The difference in ALT was statistically significant between steatosis (showed the greatest increase) and the other two groups, but not between the normal and fibrosis groups. No correlation was found between the portal pressure increase at infusion and other variables. Two patients that developed PVT on day 1 had the highest infusion pressures; a third occurred on day 5. CONCLUSION: Preexisting liver pathology is a contributing factor in the rise in liver enzymes but does not correlate with development of PV thrombosis.
Authors:
Chirag S Desai; Khalid M Khan; Felipe B Megawa; Horacio Rilo; Tun Jie; Angelika Gruessner; Rainer Gruessner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-12
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  -     ISSN:  1573-2568     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Section of Transplantation, Department of Surgery, University of Arizona, 1501 N. Campbell Ave, Tucson, AZ, 85724, USA, csdesai@gmail.com.
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