Use of D-Stat™ to Prevent Bleeding Following Percutaneous Transhepatic Intraportal Islet Transplantation

Tatiana Froud, Jose M. Yrizarry, Rodolfo Alejandro, Camillo Ricordi

Research output: Contribution to journalArticle

61 Scopus citations

Abstract

An infrequent but nevertheless concerning complication associated with percutaneous transhepatic islet transplantation is bleeding. Historically in 61 procedures at this institution, we experienced four bleeding complications in three patients (6.6%), two requiring blood transfusion (3.3%) and two asymptomatic intraperitoneal bleeds detected sonographically at 24 h postprocedure (3.3%). It is suggested that the source of the majority of these bleeds is the liver parenchymal tract following removal of the infusion catheter combined with a significant dose of heparin administered to prevent portal vein thrombosis. Various techniques have been used to reduce the risk of tract bleeding, including gelfoam, intravascular coils, and cautery. In our experience gelfoam alone has been used to plug the catheter tract (n = 47); however, in the aforementioned three patients, this technique failed, either due to dislodgement of, or bleeding peripheral to, the plug. This article describes the use of D-Stat™, a collagen/thrombin paste that is injected into the peripheral tract. In five consecutive cases performed using D-Stat™, there has been no bleeding or thromboses detected. D-Stat™ combined with a single gelfoam plug offers a quick, easy, efficacious way of sealing the entire catheter tract without leaving any permanent hardware in the liver. This new method may simplify tract closure and reduce bleeding complications in islet transplantation.

Original languageEnglish (US)
Pages (from-to)55-59
Number of pages5
JournalCell Transplantation
Volume13
Issue number1
DOIs
StatePublished - Jan 1 2004

Keywords

  • Bleeding
  • D-Stat™
  • Gelfoam plugs
  • Percutaneous transhepatic islet transplantation

ASJC Scopus subject areas

  • Cell Biology
  • Transplantation

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