Portal Thrombosis Preventable in Islet Transplantation

Heparinization, ablation of portal catheter tract, limiting packed cell volume prevent thrombosis

FRIDAY, Dec. 2 (HealthDay News) -- For patients undergoing percutaneous islet implantation, portal venous thrombosis (PVT) can be prevented by therapeutic anticoagulation, ablation of the portal catheter tract, and limiting packed cell volume (PCV), according to a study published in the December issue of the American Journal of Transplantation.

T. Kawahara, from the University of Alberta in Edmonton, Canada, and colleagues reported their large, single-center experience of percutaneous islet implantation, and evaluated the risk factors of PVT and graft function. Data from 122 individuals with 268 intraportal islet transplants were analyzed. The patients underwent portal venous Doppler ultrasound on days one and seven post-transplant.

The investigators found that, in the 101 islet transplant procedures performed over the last five years, portal thrombosis was completely prevented by therapeutic heparinization, complete ablation of the portal catheter tract with Avitene paste, and limiting PCV to less than 5 mL. Partial thrombosis did not affect islet function, based on previous cumulative experience. PCV was positively associated with, and standard liver volume was negatively associated with a rise in portal pressure. Overall, after 10 procedures, partial portal thrombosis occurred (overall incidence, 3.7 percent; incidence in most recent 101 cases, 0 percent). None of the patients had complete thrombosis or developed sequelae of portal hypertension.

"Portal thrombosis is a preventable complication in clinical islet transplantation, provided therapeutic anticoagulation is maintained and PCV is limited to <5 mL," the authors write.

One study author disclosed a financial tie to the pharmaceutical industry. Two of the study authors disclosed financial ties to the health care industry.

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