Fatal disseminated intravascular coagulation after autologous islet transplantation

Autologous islet transplantation after pancreatectomy has been used in the surgical management of patients with intractable pain secondary to chronic pancreatitis. Total or near total pancreatectomy invariably leads to exogenous insulin dependence in these patients unless they undergo islet transpla...

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Bibliographic Details
Published in:Human pathology 1997-11, Vol.28 (11), p.1295-1298
Main Authors: Froberg, M.Kent, Leone, John P, Jessurun, Jose, Sutherland, David E.R
Format: Article
Language:English
Subjects:
Adult
Associated diseases and complications
Biological and medical sciences
chronic pancreatitis
Diabetes Mellitus, Type 2 - complications
Diabetes. Impaired glucose tolerance
disseminated intravascular coagulation
Disseminated Intravascular Coagulation - etiology
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Fatal Outcome
Female
Humans
Immunohistochemistry
Insulin - analysis
islet transplantation
Islets of Langerhans Transplantation - adverse effects
Lung - chemistry
Lung - pathology
Medical sciences
Pancreatitis - complications
Pancreatitis - surgery
Shock, Hemorrhagic - etiology
trypsin
Trypsin - analysis
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Summary:Autologous islet transplantation after pancreatectomy has been used in the surgical management of patients with intractable pain secondary to chronic pancreatitis. Total or near total pancreatectomy invariably leads to exogenous insulin dependence in these patients unless they undergo islet transplantation. Transplantation of autologous islet cells harvested from the patient's pancreas into the liver through portal vein infusion has led to long-term euglycemia in 30% to 50% of patients. We report the development of disseminated intravascular coagulation and fatal hemorrhagic shock in a 36-year-old woman after total pancreatectomy and autologous islet transplantation through retrograde infusion into the splenic vein. We report the clinical and pathological findings and discuss the possible pathophysiological mechanisms involved in the development of disseminated intravascular coagulation after this procedure.
ISSN:0046-8177
1532-8392
DOI:10.1016/S0046-8177(97)90204-5