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 language | English |
|---|---|
| Pages (from-to) | 55-59 |
| Number of pages | 5 |
| Journal | Cell Transplantation |
| Volume | 13 |
| Issue number | 1 |
| State | Published - Mar 5 2004 |
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Keywords
- Bleeding
- D-Stat™
- Gelfoam plugs
- Percutaneous transhepatic islet transplantation
ASJC Scopus subject areas
- Cell Biology
- Transplantation
Cite this
Use of D-Stat™ to Prevent Bleeding Following Percutaneous Transhepatic Intraportal Islet Transplantation. / Froud, Tatiana; Yrizarry, Jose; Alejandro, Rodolfo; Ricordi, Camillo.
In: Cell Transplantation, Vol. 13, No. 1, 05.03.2004, p. 55-59.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Use of D-Stat™ to Prevent Bleeding Following Percutaneous Transhepatic Intraportal Islet Transplantation
AU - Froud, Tatiana
AU - Yrizarry, Jose
AU - Alejandro, Rodolfo
AU - Ricordi, Camillo
PY - 2004/3/5
Y1 - 2004/3/5
N2 - 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.
AB - 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.
KW - Bleeding
KW - D-Stat™
KW - Gelfoam plugs
KW - Percutaneous transhepatic islet transplantation
UR - http://www.scopus.com/inward/record.url?scp=1342309723&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=1342309723&partnerID=8YFLogxK
M3 - Article
C2 - 15040605
AN - SCOPUS:1342309723
VL - 13
SP - 55
EP - 59
JO - Cell Transplantation
JF - Cell Transplantation
SN - 0963-6897
IS - 1
ER -