title: A comparison of islet autotransplantation with allotransplantation and factors elevating acute portal pressure in clinical islet transplantation.
abstract: BACKGROUND
  Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification is rarely applied. In this paper we investigate factors associated with acute portal pressure rise, a known risk factor for portal vein thrombosis.
  
  
  METHODS
  Retrospective data was collected on 15 islet autotransplant and 122 allogeneic islet transplant subjects. Non-purified pancreatic cells were transplanted in islet autotransplants, and purified islet cells were transplanted in allogeneic transplants. Portal pressure was documented throughout the islet infusion.
  
  
  RESULTS
  The total numbers of transplanted islets were significantly smaller in autotransplants than allografts, although the packed cell volume in autotransplants was larger. Autoislet infusion, with a larger packed cell volume, caused higher transient portal venous pressures than allogeneic islet transplant. Univariate analysis and multivariate linear regression revealed that packed cell volume and the number of transplanted cells were significant risk factors for acute portal pressure rise in both autotransplants and allogeneic transplants.
  
  
  CONCLUSIONS
  Non-purified IAT has a higher risk for acute portal pressure rise than allogeneic islet transplantation, and the rise is associated with the packed cell volume and the number of transplanted cells. Minimization of packed cell volume and cautious monitoring of portal pressure are important to avoid potential complications of portal hypertension.
authors: Department of Surgery, University of Alberta, 2D4.44 Walter C. Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada. kawahara@juntendo.ac.jp
authors: Toshiyasu
authors: T
authors: Kawahara
authors: Tatsuya
authors: T
authors: Kin
authors: A M James
authors: AM
authors: Shapiro
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000503:physiopathology; D007275:Injections, Intravenous; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects* / Q000379:methods; D017082:Portal Pressure; D011169:Portal Vein; D011172:Portography; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D020246:Venous Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology