Department of Surgery, University of Alberta, 2D4.44 Walter C. Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada.
J Hepatobiliary Pancreat Sci. 2012 May;19(3):281-8. doi: 10.1007/s00534-011-0441-2.
Acute portal pressure rise is occasionally observed during intraportal islet infusion, especially in islet autotransplantation (IAT) where tissue purification is rarely applied. In this paper we investigate factors associated with acute portal pressure rise, a known risk factor for portal vein thrombosis.
Retrospective data was collected on 15 islet autotransplant and 122 allogeneic islet transplant subjects. Non-purified pancreatic cells were transplanted in islet autotransplants, and purified islet cells were transplanted in allogeneic transplants. Portal pressure was documented throughout the islet infusion.
The total numbers of transplanted islets were significantly smaller in autotransplants than allografts, although the packed cell volume in autotransplants was larger. Autoislet infusion, with a larger packed cell volume, caused higher transient portal venous pressures than allogeneic islet transplant. Univariate analysis and multivariate linear regression revealed that packed cell volume and the number of transplanted cells were significant risk factors for acute portal pressure rise in both autotransplants and allogeneic transplants.
Non-purified IAT has a higher risk for acute portal pressure rise than allogeneic islet transplantation, and the rise is associated with the packed cell volume and the number of transplanted cells. Minimization of packed cell volume and cautious monitoring of portal pressure are important to avoid potential complications of portal hypertension.
在门静脉内胰岛输注过程中偶尔会观察到急性门静脉压力升高，尤其是在胰岛自体移植（IAT）中，因为很少应用组织纯化。在本文中，我们研究了与急性门静脉压力升高相关的因素，这是门静脉血栓形成的已知危险因素。
回顾性收集了 15 例胰岛自体移植和 122 例同种异体胰岛移植患者的数据。非纯化的胰腺细胞在胰岛自体移植中被移植，而纯化的胰岛细胞在同种异体移植中被移植。门静脉压力在整个胰岛输注过程中都有记录。
尽管自体移植的细胞浓缩物体积较大，但自体移植中的总移植胰岛数量明显少于同种异体移植。具有更大细胞浓缩物体积的自体胰岛输注会导致比同种异体胰岛移植更高的短暂性门静脉压力升高。单因素分析和多元线性回归显示，细胞浓缩物体积和移植细胞数量是自体移植和同种异体移植中急性门静脉压力升高的显著危险因素。
非纯化的胰岛自体移植比同种异体胰岛移植有更高的急性门静脉压力升高风险，并且这种升高与细胞浓缩物体积和移植细胞数量有关。尽量减少细胞浓缩物体积并谨慎监测门静脉压力对于避免潜在的门静脉高压并发症非常重要。
