Procedure-related and medical complications in and after intraportal islet transplantation
Performed surgically or percutaneously, intraportal islet transplantation involves infusion of islet cells within the main portal vein or its tributaries. Percutaneous injection of islet cells is the most common method of intraportal islet transplantation and can be achieved transhepatically or transjugularly. In this chapter, we provide an overview of complications associated with intraportal delivery of islet cells and describe the different approaches to this method. In the first section, we delineate procedure-related complications of intraportal transplantation corresponding to each technique and provide up-to-date information regarding the incidence, risk factors, diagnostics, and management of each problem. Specifically, we discuss the most common complications that include bleeding, thrombosis, and iatrogenic injury to anatomical structures. In the second section, we highlight the medical complications related to intraportal islet transplantation that occur independently of technique. These include adverse events related to immunosuppressive therapy and liver pathologies such as hepatic steatosis and chronic portal hypertension.
