Minimal Focal Steatosis of Liver After Islet Transplantation in Humans: A Long-Term Study
Several reports have been published on islet transplantation in humans, but few data are available on the effect of islet infusion on the hepatic structure. Our aim was to evaluate in a longitudinal study the impact on the liver of intrahepatic islet transplantation. Clinical outcome
and liver imaging were evaluated in 31 cases of islet-kidney transplantation (follow-up 38 ± 4 months, range 12–96 months). Patients were divided into three groups: full function (FF, 9 cases: established insulin independence); partial function (PF, 16 cases: transient insulin
independence, prolonged C-peptide secretion); no function (NF, 6 cases: exhaustion of C-peptide secretion within the first year). Upper abdomen sonogram was regularly performed during the whole follow-up period. Percutaneous liver biopsy was performed in case of echographic abnormalities.
Multiple small areas of focal hyperechogenicity were observed in nine cases after 6–12 months. These findings were observed only in FF (two) and in PF (seven) patients. Fasting C-peptide levels at the time of echography were higher in negative than in positive patients (2.42 ±
0.16 vs. 1.51 ± 0.10 ng/ml, p = 0,0001). Liver biopsies showed focal macrovesicular steatosis, surrounded by normal liver parenchyma. Normal liver function was maintained. In conclusion, our results indicate that islet transplantation can lead to structural changes of the
liver parenchyma (focal steatosis). It is more often observed in patients with partial function. Sonogram can be considered a specific method to reveal liver changes after islet transplantation.
Document Type: Research Article
Department of Medicine, Transplant Unit, Scientific Institute San Raffaele, Vita-Salute University, 20132 Milano, Italy
Department of Radiology, Scientific Institute San Raffaele, Vita-Salute University, 20132 Milano, Italy
Department of Pathology, Scientific Institute San Raffaele, Vita-Salute University, 20132 Milano, Italy
Department of Surgery, Scientific Institute San Raffaele, Vita-Salute University, 20132 Milano, Italy
Publication date: October 1, 2005
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De Taddeo, Francesca
Di Carlo, Valerio
Del Maschio, Alessandro