November 12, 2014
Notes: Wang, An-jiang
Research Support, Non-U.S. Gov’t
Zhonghua Nei Ke Za Zhi. 2013 Aug;52(8):668-71.
Author Address: Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China. Email:email@example.com.
Reference Type: Journal Article
Record Number: 4819Author: Wang, L. J., Young, S., Misawa, R., Azzam, R., Wang, X., Golab, K., Cochet, O., Savari, O., Tibudan, M., Millis, J. M., Matthews, J. B. and Witkowski, P.
Title: Chronic pancreatitis and primary sclerosing cholangitis–first report of intrahepatic autologous islet transplantation
Journal: J Gastrointest Surg
Short Title: Chronic pancreatitis and primary sclerosing cholangitis–first report of intrahepatic autologous islet transplantation
Alternate Journal: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626 (Electronic)
Accession Number: 24297649
Abstract: BACKGROUND: We are reporting first successful intrahepatic autologous islet transplantation after total pancreatectomy in a patient with chronic pancreatitis and primary sclerosing cholangitis. METHODS: Total pancreatectomy and subsequent islet autotransplantation were performed in a 16-year-old boy with intractable pain due to chronic pancreatitis in the setting of ulcerative colitis and primary sclerosing cholangitis (PSC). Liver biopsy revealed PSC with focal bridging fibrosis. The pancreas was surgically removed and digested, and islets were isolated, highly purified, and infused intraportally. RESULTS: Over 18-month follow-up, the patient did not show progression of chronic liver disease or signs of portal hypertension. Magnetic resonance cholangiopancreatography revealed no new changes, and liver biopsy did not show progression of the periportal fibrosis. Pain medication was weaned over 12 months at which time glycemic control was excellent without exogenous insulin supplementation. HbgA1c was 5.9. Fifteen months after the procedure, stimulation with a mixed meal led to a fourfold increase of serum C-peptide and an eightfold increase of insulin level. CONCLUSION: Pancreatic autologous islets can be successfully transplanted into a liver affected by PSC without compromising hepatic or graft function. Durability of the procedure may be limited in the future by the natural course of the liver injury caused by PSC.