Islet autotransplantation in a cirrhotic liver.
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.
Bühler
L
L
Department of Surgery, University Hospital of Geneva.
Andereggen
E
E
Fournier
B
B
Cretin
N
N
Deng
S
S
Janjic
D
D
Wollheim
C
C
Morel
P
P
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
D001786:Blood Glucose