Unexpected Massive Hemothorax After Pancreatic Islet Transplantation: A Case Report

Abstract The percutaneous transhepatic portal approach is the most commonly used technique for islet transplantation, largely owing to its safety and minimally invasive characteristic. Bleeding complications after islet transplantation are rare and include portal vein thrombosis and subcapsular live...

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Bibliographic Details
Published in:Transplantation proceedings 2016, Vol.48 (1), p.285-287
Main Authors: Baltzinger, P, Moreau, F, Greget, M, Bédat, B, Berney, T, Kessler, L
Format: Article
Language:English
Subjects:
Anticoagulants - therapeutic use
Catheterization - adverse effects
Catheterization - methods
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - surgery
Embolization, Therapeutic - adverse effects
Embolization, Therapeutic - methods
Hemothorax - etiology
Heparin - therapeutic use
Humans
Islets of Langerhans Transplantation - adverse effects
Islets of Langerhans Transplantation - methods
Liver - blood supply
Male
Middle Aged
Portal Vein - surgery
Surgery
Vascular Surgical Procedures - adverse effects
Vascular Surgical Procedures - methods
Venous Thrombosis - etiology
Venous Thrombosis - prevention & control
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Summary:Abstract The percutaneous transhepatic portal approach is the most commonly used technique for islet transplantation, largely owing to its safety and minimally invasive characteristic. Bleeding complications after islet transplantation are rare and include portal vein thrombosis and subcapsular liver hematoma. We report a massive hemothorax after portal vein catheterization in a patient with brittle type 1 diabetes undergoing hepatic islet embolization. The patient was under long-term aspirin therapy because of vascular complications and received heparin in low doses to prevent the instant blood-mediated inflammatory reaction and reduce the risk of portal vein thrombosis. The present case illustrates the particular risk of bleeding complications in patients with brittle type 1 diabetes, who represent a frail population. This uncommon adverse event highlights the importance of close monitoring in the first days following islet transplantation.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2015.12.019