Transaminitis after pancreatic islet transplantation

Neal R. Barshes, Timothy C. Lee, Sarah E. Goodpastor, Rajesh Balkrishnan, A. Paige Schock, Amy Mote, F. Charles Brunicardi, Rodolfo Alejandro, Camillo Ricordi, John A. Goss

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

BACKGROUND: An asymptomatic, self-limited transaminitis uniformly follows pancreatic islet transplantation (PIT) performed through portal vein (PV) infusion. The underlying cause and significance of this transaminitis is unclear. STUDY DESIGN: Records of all patients with insulin-dependent diabetes mellitus who had undergone PIT at our institution were reviewed. All PITs were performed in conjunction with a remote pancreatic islet isolation center and done through percutaneous transhepatic PV infusion. Alanine aminotransferase (ALT) levels, serum glucose concentrations, insulin requirements, and color-flow Doppler ultrasonography examinations of the right upper quadrant were assessed before and after PIT. RESULTS: Eleven patients have undergone a total of 26 PITs. An elevated ALT level occurred in all 11 patients (100%) after the first PIT, with the median post-PIT peak ALT level reaching 187 IU/L. Transaminitis was less frequent and less marked after the second PIT. A negative correlation between viability of the pancreatic islets transplanted (r = -0.44, p = 0.03) and a positive correlation between the ratio of maximum to initial PV pressure (r = 0.41, p = 0.04) were seen with the subsequent ALT peak. Color-flow Doppler ultrasonography examinations showed no occurrences of PV thrombosis or intrahepatic hematoma. Finally, the degree of transaminitis did not correlate with post-PIT insulin requirements, indicating that post-PIT transaminitis cannot be used to measure allograft rejection or function. CONCLUSIONS: Transaminitis after PIT is common and self-limited. Post-PIT transaminitis does not signal acute rejection or serious procedure-related complications such as PV thrombosis or intrahepatic hematoma.

Original languageEnglish (US)
Pages (from-to)353-361
Number of pages9
JournalJournal of the American College of Surgeons
Volume200
Issue number3
DOIs
StatePublished - Mar 2005

ASJC Scopus subject areas

  • Surgery

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    Barshes, N. R., Lee, T. C., Goodpastor, S. E., Balkrishnan, R., Schock, A. P., Mote, A., Brunicardi, F. C., Alejandro, R., Ricordi, C., & Goss, J. A. (2005). Transaminitis after pancreatic islet transplantation. Journal of the American College of Surgeons, 200(3), 353-361. https://doi.org/10.1016/j.jamcollsurg.2004.10.021