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. Matsumoto^2
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. Matsumoto^2
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.