title: Minimal focal steatosis of liver after islet transplantation in humans: a long-term study.
abstract: Several reports have been published on islet transplantation in humans, but few data are available on the effect of islet infusion on the hepatic structure. Our aim was to evaluate in a longitudinal study the impact on the liver of intrahepatic islet transplantation. Clinical outcome and liver imaging were evaluated in 31 cases of islet-kidney transplantation (follow-up 38 +/- 4 months, range 12-96 months). Patients were divided into three groups: full function (FF, 9 cases: established insulin independence); partial function (PF, 16 cases: transient insulin independence, prolonged C-peptide secretion): no function (NF, 6 cases: exhaustion of C-peptide secretion within the first year). Upper abdomen sonogram was regularly performed during the whole follow-up period. Percutaneous liver biopsy was performed in case of echographic abnormalities. Multiple small areas of focal hyperechogenicity were observed in nine cases after 6-12 months. These findings were observed only in FF (two) and in PF (seven) patients. Fasting C-peptide levels at the time of echography were higher in negative than in positive patients (2.42 +/- 0.16 vs. 1.51 +/- 0.10 ng/ml, p = 0,0001). Liver biopsies showed focal macrovesicular steatosis, surrounded by normal liver parenchyma. Normal liver function was maintained. In conclusion, our results indicate that islet transplantation can lead to structural changes of the liver parenchyma (focal steatosis). It is more often observed in patients with partial function. Sonogram can be considered a specific method to reveal liver changes after islet transplantation.
authors.affiliation: Department of Medicine, Transplant Unit, Scientific Institute San Raffaele, Vita-Salute University, Milano, Italy. paola.maffi@hsr.it
authors.forename: Paola
authors.initials: P
authors.lastname: Maffi
authors.forename: Enzo
authors.initials: E
authors.lastname: Angeli
authors.forename: Federico
authors.initials: F
authors.lastname: Bertuzzi
authors.forename: Carlo
authors.initials: C
authors.lastname: Paties
authors.forename: Carlo
authors.initials: C
authors.lastname: Socci
authors.forename: Carlo
authors.initials: C
authors.lastname: Fedeli
authors.forename: Francesca
authors.initials: F
authors.lastname: De Taddeo
authors.forename: Rita
authors.initials: R
authors.lastname: Nano
authors.forename: Valerio
authors.initials: V
authors.lastname: Di Carlo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Maschio
authors.forename: Antonio
authors.initials: A
authors.lastname: Secchi
mesh_terms: D000328:Adult; D001706:Biopsy; D002096:C-Peptide / Q000097:blood; D002465:Cell Movement; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000601:surgery*; D005234:Fatty Liver / Q000097:blood / Q000209:etiology* / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects*; D016030:Kidney Transplantation; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008137:Longitudinal Studies; D010179:Pancreas / Q000502:physiology / Q000503:physiopathology; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D002096:C-Peptide; D007328:Insulin