Document Detail


Insulin independence achieved using the transmesenteric approach to the portal vein for islet transplantation.
MedLine Citation:
PMID:  14742999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clinical human islet transplantation has been performed successfully using a percutaneous transhepatic approach to access the portal vein. The risks from percutaneous delivery of islets, such as bleeding and puncturing neighboring structures, can be avoided by a transmesenteric approach to the portal vein, which we have used to stent completely or near-completely occluded portal veins in both cirrhotic and noncirrhotic patients with minimum morbidity. After minilaparotomy, a second-order tributary branch of the mesenteric vein is cannulated to provide endovascular access to the portal vein. The islet preparation is infused through a catheter directed under fluoroscopy from the mesenteric vein to the portal vein. Pre- and postinfusion portograms are obtained to confirm the absence of any interval changes in portal venous flow. We have performed this procedure successfully in three islet-transplant recipients each receiving two infusions on separate occasions, with some of these procedures performed under local anesthesia without complications. The transmesenteric approach promises to be a safe alternative to percutaneous islet delivery.
Authors:
A Osama Gaber; Abbas Chamsuddin; Daniel Fraga; Jonathan Fisher; Agnes Lo
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Transplantation     Volume:  77     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-26     Completed Date:  2004-02-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  309-11     Citation Subset:  IM    
Affiliation:
Department of Surgery, Division of Transplantation, University of Tennessee Health Science Center, Memphis, TN 38163, USA. agaber@utmem.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / metabolism*
Diabetes Mellitus, Type 1 / blood,  surgery*
Female
Humans
Islets of Langerhans Transplantation / methods*,  physiology
Mesenteric Veins / surgery*
Portal Vein / surgery*
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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