Detection of intrahepatic human islets following combined liver-islet allotransplantation.
This article describes the localization of intact insulin-containing intrahepatic islets after combined liver-islet allotransplantation. The patient was a 36-year-old woman who underwent upper abdominal exenteration for neuroendocrine carcinoma; 289,000 islets were transplanted via portal vein infusion immediately after complete revascularization of the liver. Immunosuppression was with low-dose FK-506. OKT3 and steroids were used to treat one rejection episode 2 weeks after transplantation, but the patient subsequently developed multiple infections and died 109 days after transplantation. At autopsy, the transplanted liver did not show any sign of rejection and well-preserved islets were present in portal triads sampled from the anterior inferior edge of the right lobe. Immunohistochemical labeling confirmed the presence of insulin-containing cells. This finding indicated that human islets can survive after intrahepatic allotransplantation, despite positive cross-match with no HLA antigen match, suggesting that upper abdominal exenteration and liver transplantation may constitute a protective factor for the survival of allogeneic human islets.
Ricordi
C
C
Department of Surgery, University of Pittsburgh School of Medicine, Pennsylvania 15213.
Tzakis
A
A
Alejandro
R
R
Zeng
Y
Y
Demetris
A J
AJ
Carroll
P
P
Fung
J J
JJ
Mintz
D H
DH
Starzl
T E
TE
D000328:Adult; D001344:Autopsy; D005260:Female; D006648:Histocompatibility; D006801:Humans; D007150:Immunohistochemistry; D007328:Insulin / Q000032:analysis; D007515:Islets of Langerhans / Q000737:chemistry / Q000276:immunology / Q000473:pathology*; D016381:Islets of Langerhans Transplantation / Q000276:immunology / Q000473:pathology*; D008099:Liver / Q000737:chemistry / Q000276:immunology / Q000473:pathology*; D016031:Liver Transplantation / Q000276:immunology / Q000473:pathology*; D014184:Transplantation, Homologous
D007328:Insulin