Intraportal Autoislet Cell Transplantation (IAT): Changes in Portal Pressure and Flow and Associated Clinical Outcomes

T. Dunn, M. Bellin, J. Wilhelm, A. Balamurugan, G. Beilman, S. Chinnakotla, S. Vickers, D. Sutherland, T. Pruett

Surgery, University of MN, Mpls, MN

Meeting: 2013 American Transplant Congress

Abstract number: C1403

IAT tissue volume (TV) delivered into the portal venous system can be associated with acute portal hypertension. We analyzed the relationships between transplanted TV, portal vein (PV) pressure and PV flow, as well as the timing and nature of complications.

Methods: Between 7/2011 and 11/2012 we studied 39 total pancreatectomy IAT patients who underwent pre- and post-infusion portal pressure and blood flow measurements. TV (ml), islet equivalents/kg, PV pressure and PV flow (pre-infusion, peak post infusion, and post-infusion) were evaluated for the cohort. Patients were evaluated for PV thrombotic complications. The correlations between changes in PV flow, pressure and tissue volume were evaluated.

Table 1
	Mean	SD	Min	Max
Baseline pressure (cmH20)	1.6	3.3	-4	13
Baseline flow (L/min)	0.627	0.31	0.14	1.4
Peak Pressure (cmH20)	20.63	9.87	5	40
Delta Pressure (cmH20)	19.15	9.45	3	39
Peak Flow (L/min)	0.348	0.35	0.08	1.6
Final Pressure (cmH20)	18	9	3.5	39
Final Flow (L/min)	0.356	0.31	0.04	1.5
Tissue pellet (ml)	13.65	5.98	1	30

Results: Transplant data for the cohort are shown in Table 1. We found correlation between the delta PV pressure (peak minus baseline) and PV final flow rates (r=-0.67, p<0.0001), as well as TV and PV flow (r=-.063), p<0.0001). 3 patients had transient perterbations in flow; reversal of flow or no flow in the left PV, detected within a week of transplant. However, these resolved within a few weeks. We observed no episodes of main PV thrombosis.

Conclusion: Autoislet cell transplant is associated with sometimes significant acute portal hypertension. PV pressures and TV both correlate with final PV flow. No serious/persistent complications were observed. Real-time PV flow measurements may be more useful than intermittent PV pressure measurements during Tx.

To cite this abstract in AMA style:

Dunn T, Bellin M, Wilhelm J, Balamurugan A, Beilman G, Chinnakotla S, Vickers S, Sutherland D, Pruett T. Intraportal Autoislet Cell Transplantation (IAT): Changes in Portal Pressure and Flow and Associated Clinical Outcomes [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/intraportal-autoislet-cell-transplantation-iat-changes-in-portal-pressure-and-flow-and-associated-clinical-outcomes/. Accessed November 22, 2024.

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