title: Islet autotransplantation in a cirrhotic liver.
abstract: Chronic pancreatitis resulting from alcohol abuse might in some rare cases require a total surgical resection of the pancreas to treat severe local complications. We have learned from the new techniques developed for islet isolation that it is now possible to obtain a sufficient number of good quality islets from one single pancreas to be transplanted into one recipient. We present a case of total surgical pancreatectomy for chronic pancreatitis in a previously non-diabetic patient with immediate islet isolation and autotransplantation. At operation, a cirrhotic liver was found, but no portal hypertension. We still decided to embolize a non purified preparation of endocrine tissue into the liver without alteration of liver function or durable modification of the portal pressure. One year after this procedure, the patient remains insulin-independent with a close to normal glycemic regulation as demonstrated by stimulation tests. Islet autotransplantation does not appear to be generally contra-indicated in the presence of a cirrhotic liver; provided the portal pressure is within normal limits. Under these circumstances, satisfactory glycemic control is achieved.
authors.affiliation: Department of Surgery, University Hospital of Geneva.
authors.forename: L
authors.initials: L
authors.lastname: Bühler
authors.forename: E
authors.initials: E
authors.lastname: Andereggen
authors.forename: B
authors.initials: B
authors.lastname: Fournier
authors.forename: N
authors.initials: N
authors.lastname: Cretin
authors.forename: S
authors.initials: S
authors.lastname: Deng
authors.forename: D
authors.initials: D
authors.lastname: Janjic
authors.forename: C
authors.initials: C
authors.lastname: Wollheim
authors.forename: P
authors.initials: P
authors.lastname: Morel
mesh_terms: D001786:Blood Glucose; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000209:etiology; D005260:Female; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D008103:Liver Cirrhosis / Q000150:complications*; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010195:Pancreatitis / Q000150:complications / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose