title: Fatal disseminated intravascular coagulation after autologous islet transplantation.
abstract: Autologous islet transplantation after pancreatectomy has been used in the surgical management of patients with intractable pain secondary to chronic pancreatitis. Total or near total pancreatectomy invariably leads to exogenous insulin dependence in these patients unless they undergo islet transplantation. Transplantation of autologous islet cells harvested from the patient's pancreas into the liver through portal vein infusion has led to long-term euglycemia in 30% to 50% of patients. We report the development of disseminated intravascular coagulation and fatal hemorrhagic shock in a 36-year-old woman after total pancreatectomy and autologous islet transplantation through retrograde infusion into the splenic vein. We report the clinical and pathological findings and discuss the possible pathophysiological mechanisms involved in the development of disseminated intravascular coagulation after this procedure.
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis 55455, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Froberg
authors.forename: J P
authors.initials: JP
authors.lastname: Leone
authors.forename: J
authors.initials: J
authors.lastname: Jessurun
authors.forename: D E
authors.initials: DE
authors.lastname: Sutherland
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007328:Insulin / Q000032:analysis; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects*; D008168:Lung / Q000737:chemistry / Q000473:pathology; D010195:Pancreatitis / Q000150:complications / Q000601:surgery; D012771:Shock, Hemorrhagic / Q000209:etiology; D014357:Trypsin / Q000032:analysis
chemical_list: D007328:Insulin; D014357:Trypsin