METABOLIC STUDIES FOLLOWING INTRA-HEPATIC AUTO-TRANSPLANTATION OF PANCREATIC-ISLET GRAFTS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 87  (4) , 397-400
Abstract
A patient with chronic pancreatitis underwent 95% pancreatectomy and islet autotransplantation. The pancreatic tissue was prepared by mincing and collagenase digestion, and then embolized into the liver via the portal vein. The patient has been followed with metabolic studies for 1 yr. Fasting normoglycemia returned 3 wk following operation. I.v. glucose tolerance tests revealed K values that were similar before operation (1.06), and 3 wk (0.96) and 4 mo. (1.09) after operation. Four mo. after islet transplantation, peripheral, portal, and hepatic vein insulin levels were determined simultaneously following an infusion of glucose (0.25 mg/kg) into the portal vein. During a 10 min interval, right hepatic vein insulin increased 4-fold, left hepatic vein insulin increased 2-fold, and peripheral vein insulin doubled. During this time, portal vein insulin remained constant. Significant levels of pancreatic glucagon were present in both hepatic veins, but were undetectable in the portal vein. At 6 mo., the patient became hyperglycemic and subsequently has required insulin therapy. Restudy at 10 mo. following islet transplantation revealed a marked drop in K value (0.34), and no evidence of graft function in the liver. Transplanted intrahepatic islet cells may function for a 6 mo. period following operation. The grafts for unknown reasons ceased to function at 6 mo.

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