Ultrasound-Guided Human Islet Transplantation: Safety, Feasibility, and Efficacy Analysis

Daopeng Yang; Bowen Zhuang; Jinliang Duan; Fang Bai; Zepeng Lin; Xue Ma; Shan Guo; Xiaoshun He; Xiaofeng Zhu; Xiaohua Xie; Xiaoyan Xie; Anbin Hu

doi:10.1016/j.acra.2023.04.024

Ultrasound-Guided Human Islet Transplantation: Safety, Feasibility, and Efficacy Analysis

Acad Radiol. 2023 Sep:30 Suppl 1:S268-S277. doi: 10.1016/j.acra.2023.04.024. Epub 2023 Jun 4.

Authors

Daopeng Yang¹, Bowen Zhuang², Jinliang Duan¹, Fang Bai¹, Zepeng Lin¹, Xue Ma¹, Shan Guo², Xiaoshun He¹, Xiaofeng Zhu¹, Xiaohua Xie², Xiaoyan Xie², Anbin Hu³

Affiliations

¹ Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), No. 58 Zhongshan Road 2, Guangzhou 510080, China.
² Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
³ Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), No. 58 Zhongshan Road 2, Guangzhou 510080, China. Electronic address: anbinhu@163.com.

PMID: 37280129
DOI: 10.1016/j.acra.2023.04.024

Abstract

Rationale and objectives: We aimed to analyze the safety, feasibility, and efficacy of human islet transplantation (IT) using ultrasound (US) throughout the entire procedure.

Materials and methods: A total of 22 recipients (18 males; mean age 42.6 ± 17.5years) with 35 procedures were retrospective included. Under US guidance, percutaneous transhepatic portal catheterization was successfully performed through a right-sided transhepatic approach, and islets were infused into the main portal vein. Color Doppler and contrast-enhanced ultrasound were used to guide the procedure and monitor the complications. After infusion of the islet mass, the access track was embolized by embolic material. If hemorrhage persisted, US-guided radiofrequency ablation (RFA) was performed to stop bleeding. Factors that could affect the complication were analyzed. After transplantation, primary graft function was evaluated with a β-score 1month after the last islet infusion.

Results: The technical success rates were 100% with a single puncture attempt. Six (17.1%) abdominal bleeding episodes were immediately stopped by US-guided RFA. No portal vein thrombosis were encountered. Dialysis (OR (Odd Ratio): 32.0; 95% CI: 1.561-656.054; and P = .025) was identified as a significant factor associated with bleeding. Primary graft function was optimal in eight patients (36.4%), suboptimal in 13 patients (59.1%), and poor in one patient (4.5%).

Conclusion: In conclusion, whole-procedure US-guided IT is a safe, feasible, and effective method for diabetes. Complications are either self-limiting or manageable with noninvasive treatment.

Keywords: Contrast-enhanced ultrasound; Islet transplantation; Radiofrequency ablation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Feasibility Studies
Humans
Islets of Langerhans Transplantation* / methods
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Ultrasonography, Interventional