title: Percutaneous transhepatic portal catheterization guided by ultrasound technology for islet transplantation in rhesus monkey.
abstract: BACKGROUND
  Pig islet xenotransplantation has the potential to overcome the shortage of donated human islets for islet cell transplantation in type 1 diabetes. Testing in non-human primate models is necessary before clinical application in humans. Intraportal islet transplantation in monkeys is usually performed by surgical infusion during laparotomy or laparoscopy. In this paper, we describe a new method of percutaneous transhepatic portal catheterization (PTPC) as an alternative to current methods of islet transplantation in rhesus monkeys.
  
  
  METHODS
  We performed ultrasound-guided PTPC in five adult rhesus monkeys weighing 7-8 kg, with portal vein catheterization confirmed by digital subtraction angiography. We monitored for complications in the thoracic and abdominal cavity. To evaluate the safety of ultrasound-guided PTPC, we recorded the changes in portal pressure throughout the microbead transplantation procedure.
  
  
  RESULTS
  Ultrasound-guided PTPC and infusion of 16 000 microbeads/kg body weight into the portal vein was successful in all five monkeys. Differences in the hepatobiliary anatomy of rhesus monkeys compared to humans led to a higher initial complication rate. The first monkey died of abdominal hemorrhage 10 hours post-transplantation. The second suffered from a mild pneumothorax but recovered fully after taking only conservative measures. After gaining experience with the first two monkeys, we decreased both the hepatic puncture time and the number of puncture attempts required, with the remaining three monkeys experiencing no complications. Portal pressures initially increased proportional to the number of transplanted microbeads but returned to pre-infusion levels at 30 minutes post-transplantation. The changes in portal pressures occurring during the procedure were not significantly different.
  
  
  CONCLUSIONS
  Ultrasound-guided PTPC is an effective, convenient, and minimally invasive method suitable for use in non-human primate models of islet cell transplantation provided that care is taken with hepatic puncture. Its advantages must be weighed against the risks of procedure-related complications.
authors.affiliation: Cell Transplantation & Gene Therapy Institute, Third Xiangya Hospital, Changsha 410013, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Shao-Dong
authors.initials: SD
authors.lastname: Ai
authors.forename: Sheng
authors.initials: S
authors.lastname: Liu
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Zeng
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
mesh_terms: D000818:Animals; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000379:methods*; D008253:Macaca mulatta / Q000601:surgery*; D008863:Microspheres; D023421:Models, Animal; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D014463:Ultrasonography / Q000379:methods*