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Presenter: M. , Levy1, ,
Authors: M. Levy1, M. Takita2, M. Shimoda3, K. Sugimoto2, T. Itoh2, D. Chujo4, J. SoRelle5, Y. Tamura1, A. Rahman1, N. Onaca1, B. Naziruddin1, S. Matsumoto2
P-220
Analysis of portal thrombosis in clinical autologous islet transplantation
M. Levy1, M. Takita2, M. Shimoda3, K. Sugimoto2, T. Itoh2, D. Chujo4, J. SoRelle5, Y. Tamura1, A. Rahman1, N. Onaca1, B. Naziruddin1, S. Matsumoto2
1 Baylor Regional Transplant Institute, Dallas, USA; 2 Baylor Research Institute, Islet Cell Laboratory, Fort Worth, USA; 3 Baylor University Medical Center, Dallas, USA; 4 Baylor Institute for Immunology Research, Dallas, USA; 5 Baylor University, Waco, USA
Autologousislet transplantation after total pancreatectomy is an excellent treatment for patientswith severe chronic pancreatitis. Portalthrombosis is one of the complications; however, no detailedanalysis was reported. The purpose ofthis study is to analyze the cases of portal thrombosis after autologous islettransplantation.
Method: Twenty-seven cases of autologous islet transplantation were analyzed. Patient background, islet characteristics andclinical outcomes were compared between the cases with (thrombosis group; TG,N=3) or without (non-thrombosis group: NG, N=24) portal thrombosis. The portal pressures of pre-transplantation(base), maximum values (max), at the end of transplantation (final) and thedifferences between max and base (delta) values were also compared.
Results: There were no significant differences in patient age, body weight, BMI, pancreasweight between the TG and NG. The tissuevolume was significantly higher in the TG (16.7±1.7 vs. 9.0±1.0mL, TG vs. NG, P<0.02). The islet yield was higher in the TG (672,359±101,579vs. 381,143±50,926, TG vs. NG, P=0.06) and islet yield per pancreas weightwas significantly higher in the TG (7,525±1,472 vs. 4,095±447IE/g, P<0.02). There were nosignificant differences of purity and viability between the two groups. There was no significant difference in basalportal pressure (7.0±2.5; TG vs. 8.2±0.9 mmHg; NG) between the twogroups. Both max (22.2±2.6;TG vs. 16.7±1.7mmHg; NG) and final portal pressure (20.2±2.3;TG vs. 14.1±1.1 mmHg; NG) were higher in the TG but did not reachsignificance. The delta portal pressurewas significantly higher in the TG (17.0±1.5 vs. 8.3±1.3mmHg, P<0.03). Ten out of 24 patients(42%) in NG but none of 3 patients (0%) achieved insulin independence in TG.
Conclusion: Large tissue volume and high delta portal pressure were associated with portalthrombosis after autologous islet transplantation that might result in poorengraftment.
/P-220
Analysis of portal thrombosis in clinical autologous islet transplantation
M. Levy1, M. Takita2, M. Shimoda3, K. Sugimoto2, T. Itoh2, D. Chujo4, J. SoRelle5, Y. Tamura1, A. Rahman1, N. Onaca1, B. Naziruddin1, S. Matsumoto2
1 Baylor Regional Transplant Institute, Dallas, USA; 2 Baylor Research Institute, Islet Cell Laboratory, Fort Worth, USA; 3 Baylor University Medical Center, Dallas, USA; 4 Baylor Institute for Immunology Research, Dallas, USA; 5 Baylor University, Waco, USA
Autologousislet transplantation after total pancreatectomy is an excellent treatment for patientswith severe chronic pancreatitis. Portalthrombosis is one of the complications; however, no detailedanalysis was reported. The purpose ofthis study is to analyze the cases of portal thrombosis after autologous islettransplantation.
Method: Twenty-seven cases of autologous islet transplantation were analyzed. Patient background, islet characteristics andclinical outcomes were compared between the cases with (thrombosis group; TG,N=3) or without (non-thrombosis group: NG, N=24) portal thrombosis. The portal pressures of pre-transplantation(base), maximum values (max), at the end of transplantation (final) and thedifferences between max and base (delta) values were also compared.
Results: There were no significant differences in patient age, body weight, BMI, pancreasweight between the TG and NG. The tissuevolume was significantly higher in the TG (16.7±1.7 vs. 9.0±1.0mL, TG vs. NG, P<0.02). The islet yield was higher in the TG (672,359±101,579vs. 381,143±50,926, TG vs. NG, P=0.06) and islet yield per pancreas weightwas significantly higher in the TG (7,525±1,472 vs. 4,095±447IE/g, P<0.02). There were nosignificant differences of purity and viability between the two groups. There was no significant difference in basalportal pressure (7.0±2.5; TG vs. 8.2±0.9 mmHg; NG) between the twogroups. Both max (22.2±2.6;TG vs. 16.7±1.7mmHg; NG) and final portal pressure (20.2±2.3;TG vs. 14.1±1.1 mmHg; NG) were higher in the TG but did not reachsignificance. The delta portal pressurewas significantly higher in the TG (17.0±1.5 vs. 8.3±1.3mmHg, P<0.03). Ten out of 24 patients(42%) in NG but none of 3 patients (0%) achieved insulin independence in TG.
Conclusion: Large tissue volume and high delta portal pressure were associated with portalthrombosis after autologous islet transplantation that might result in poorengraftment.
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