title: Unexpected Massive Hemothorax After Pancreatic Islet Transplantation: A Case Report.
abstract: The percutaneous transhepatic portal approach is the most commonly used technique for islet transplantation, largely owing to its safety and minimally invasive characteristic. Bleeding complications after islet transplantation are rare and include portal vein thrombosis and subcapsular liver hematoma. We report a massive hemothorax after portal vein catheterization in a patient with brittle type 1 diabetes undergoing hepatic islet embolization. The patient was under long-term aspirin therapy because of vascular complications and received heparin in low doses to prevent the instant blood-mediated inflammatory reaction and reduce the risk of portal vein thrombosis. The present case illustrates the particular risk of bleeding complications in patients with brittle type 1 diabetes, who represent a frail population. This uncommon adverse event highlights the importance of close monitoring in the first days following islet transplantation.
authors.affiliation: Department of Diabetology, University Hospital, Strasbourg, France; Fédération de Médecine Translationnelle, University of Strasbourg, Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Baltzinger
authors.affiliation: Department of Diabetology, University Hospital, Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Moreau
authors.affiliation: Department of Radiology, University Hospital, Strasbourg, France.
authors.forename: M
authors.initials: M
authors.lastname: Greget
authors.affiliation: Laboratory of Cellular Therapy, University Hospital, Geneva, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Bédat
authors.affiliation: Laboratory of Cellular Therapy, University Hospital, Geneva, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Berney
authors.affiliation: Department of Diabetology, University Hospital, Strasbourg, France; Fédération de Médecine Translationnelle, University of Strasbourg, Strasbourg, France. Electronic address: laurence.kessler@chru-strasbourg.fr.
authors.forename: L
authors.initials: L
authors.lastname: Kessler
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D002404:Catheterization / Q000009:adverse effects / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D006491:Hemothorax / Q000209:etiology*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects* / Q000379:methods; D008099:Liver / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006493:Heparin