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Transaminitis after pancreatic islet transplantation
Neal R Barshes1, Timothy C Lee, Sarah E Goodpastor
1Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
Journal of the American College of Surgeons
|March 2, 2005
Summary
Transaminitis after pancreatic islet transplantation (PIT) is common and resolves on its own. This liver enzyme elevation does not indicate transplant rejection or serious complications.
Area of Science:
- Hepatology
- Transplantation Immunology
- Endocrinology
Background:
- Pancreatic islet transplantation (PIT) frequently causes asymptomatic transaminitis.
- The cause and clinical significance of this liver enzyme elevation post-PIT remain unclear.
Purpose of the Study:
- To investigate the cause and significance of transaminitis following pancreatic islet transplantation (PIT).
- To assess the relationship between transaminitis and transplant outcomes, including rejection and complications.
Main Methods:
- Retrospective review of patients with insulin-dependent diabetes mellitus undergoing PIT via percutaneous transhepatic portal vein (PV) infusion.
- Assessment of alanine aminotransferase (ALT) levels, glucose, insulin requirements, and Doppler ultrasonography before and after PIT.
Main Results:
- All patients (100%) experienced elevated ALT after the first PIT, with a median peak of 187 IU/L.
- Transaminitis was less frequent and severe after subsequent PITs.
- Elevated ALT correlated negatively with islet viability and positively with PV pressure ratio, but not with insulin requirements or procedure-related complications.
Conclusions:
- Transaminitis following PIT is a common, self-limited event.
- Post-PIT transaminitis does not indicate acute rejection or serious complications like PV thrombosis or hematoma.