Liver perfusion changes occurring during pancreatic islet engraftment: A dynamic contrast-enhanced magnetic resonance study

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Abstract

The aim of this study was to investigate liver microvascular adaptation following the intraportal infusion of pancreatic islets (pancreatic islet transplantation [islet-tx]) in diabetic patients using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI was performed before and 7 days after islet-tx in six diabetic patients. Initial area under curve (AUC60) and volume transfer coefficient (Ktrans) were assessed as markers of liver perfusion. Clinical and metabolic monthly follow-up was performed in all patients, considering fasting C-peptide and β-score as main indices of graft function. High variability in the response of liver microvasculature to islet infusion was observed: two patients showed a significant reduction in liver perfusion after transplantation (pt.2: AUC60 = -23.4%, Ktrans = -31.7%; pt.4: AUC60 = -23.7%, Ktrans = -27.9%); three patients did not show any significant variation of liver perfusion and one patient showed a significant increase (pt.3: AUC60 = +31%, Ktrans = +42.8%). Interestingly, a correlation between DCE-MRI parameters and indices of graft function was observed and, in particular, both patients with DCE-MRI evidence of posttransplantation liver perfusion reduction experienced premature graft failure. Our preliminary study demonstrated that DCE-MRI may identify different adaptive responses of liver microvasculature in patients submitted to islet-tx. These different responses could have an impact on islet engraftment, although reported findings need confirmation from larger studies. This study shows that dynamic contrast-enhanced magnetic resonance imaging identifies various adaptive responses of the liver microvasculature in islet transplant recipients and that these responses might have an impact on islet engraftment.

Original languageEnglish
Pages (from-to)202-209
Number of pages8
JournalAmerican Journal of Transplantation
Volume14
Issue number1
DOIs
Publication statusPublished - Jan 2014

Fingerprint

Islets of Langerhans
Magnetic Resonance Spectroscopy
Perfusion
Liver
Magnetic Resonance Imaging
Microvessels
Transplants
Islets of Langerhans Transplantation
C-Peptide
Area Under Curve
Fasting
Transplantation

Keywords

  • DCE-MRI
  • liver microvascular changes
  • pancreatic islet transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

@article{b2253a0d36bb4049b2a4803f61f3efbf,
title = "Liver perfusion changes occurring during pancreatic islet engraftment: A dynamic contrast-enhanced magnetic resonance study",
abstract = "The aim of this study was to investigate liver microvascular adaptation following the intraportal infusion of pancreatic islets (pancreatic islet transplantation [islet-tx]) in diabetic patients using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI was performed before and 7 days after islet-tx in six diabetic patients. Initial area under curve (AUC60) and volume transfer coefficient (Ktrans) were assessed as markers of liver perfusion. Clinical and metabolic monthly follow-up was performed in all patients, considering fasting C-peptide and β-score as main indices of graft function. High variability in the response of liver microvasculature to islet infusion was observed: two patients showed a significant reduction in liver perfusion after transplantation (pt.2: AUC60 = -23.4{\%}, Ktrans = -31.7{\%}; pt.4: AUC60 = -23.7{\%}, Ktrans = -27.9{\%}); three patients did not show any significant variation of liver perfusion and one patient showed a significant increase (pt.3: AUC60 = +31{\%}, Ktrans = +42.8{\%}). Interestingly, a correlation between DCE-MRI parameters and indices of graft function was observed and, in particular, both patients with DCE-MRI evidence of posttransplantation liver perfusion reduction experienced premature graft failure. Our preliminary study demonstrated that DCE-MRI may identify different adaptive responses of liver microvasculature in patients submitted to islet-tx. These different responses could have an impact on islet engraftment, although reported findings need confirmation from larger studies. This study shows that dynamic contrast-enhanced magnetic resonance imaging identifies various adaptive responses of the liver microvasculature in islet transplant recipients and that these responses might have an impact on islet engraftment.",
keywords = "DCE-MRI, liver microvascular changes, pancreatic islet transplantation",
author = "A. Esposito and A. Palmisano and P. Maffi and Malosio, {M. L.} and R. Nano and T. Canu and {De Cobelli}, F. and L. Piemonti and G. Ironi and A. Secchi and {Del Maschio}, A.",
year = "2014",
month = "1",
doi = "10.1111/ajt.12501",
language = "English",
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journal = "American Journal of Transplantation",
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T1 - Liver perfusion changes occurring during pancreatic islet engraftment

T2 - A dynamic contrast-enhanced magnetic resonance study

AU - Esposito, A.

AU - Palmisano, A.

AU - Maffi, P.

AU - Malosio, M. L.

AU - Nano, R.

AU - Canu, T.

AU - De Cobelli, F.

AU - Piemonti, L.

AU - Ironi, G.

AU - Secchi, A.

AU - Del Maschio, A.

PY - 2014/1

Y1 - 2014/1

N2 - The aim of this study was to investigate liver microvascular adaptation following the intraportal infusion of pancreatic islets (pancreatic islet transplantation [islet-tx]) in diabetic patients using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI was performed before and 7 days after islet-tx in six diabetic patients. Initial area under curve (AUC60) and volume transfer coefficient (Ktrans) were assessed as markers of liver perfusion. Clinical and metabolic monthly follow-up was performed in all patients, considering fasting C-peptide and β-score as main indices of graft function. High variability in the response of liver microvasculature to islet infusion was observed: two patients showed a significant reduction in liver perfusion after transplantation (pt.2: AUC60 = -23.4%, Ktrans = -31.7%; pt.4: AUC60 = -23.7%, Ktrans = -27.9%); three patients did not show any significant variation of liver perfusion and one patient showed a significant increase (pt.3: AUC60 = +31%, Ktrans = +42.8%). Interestingly, a correlation between DCE-MRI parameters and indices of graft function was observed and, in particular, both patients with DCE-MRI evidence of posttransplantation liver perfusion reduction experienced premature graft failure. Our preliminary study demonstrated that DCE-MRI may identify different adaptive responses of liver microvasculature in patients submitted to islet-tx. These different responses could have an impact on islet engraftment, although reported findings need confirmation from larger studies. This study shows that dynamic contrast-enhanced magnetic resonance imaging identifies various adaptive responses of the liver microvasculature in islet transplant recipients and that these responses might have an impact on islet engraftment.

AB - The aim of this study was to investigate liver microvascular adaptation following the intraportal infusion of pancreatic islets (pancreatic islet transplantation [islet-tx]) in diabetic patients using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI was performed before and 7 days after islet-tx in six diabetic patients. Initial area under curve (AUC60) and volume transfer coefficient (Ktrans) were assessed as markers of liver perfusion. Clinical and metabolic monthly follow-up was performed in all patients, considering fasting C-peptide and β-score as main indices of graft function. High variability in the response of liver microvasculature to islet infusion was observed: two patients showed a significant reduction in liver perfusion after transplantation (pt.2: AUC60 = -23.4%, Ktrans = -31.7%; pt.4: AUC60 = -23.7%, Ktrans = -27.9%); three patients did not show any significant variation of liver perfusion and one patient showed a significant increase (pt.3: AUC60 = +31%, Ktrans = +42.8%). Interestingly, a correlation between DCE-MRI parameters and indices of graft function was observed and, in particular, both patients with DCE-MRI evidence of posttransplantation liver perfusion reduction experienced premature graft failure. Our preliminary study demonstrated that DCE-MRI may identify different adaptive responses of liver microvasculature in patients submitted to islet-tx. These different responses could have an impact on islet engraftment, although reported findings need confirmation from larger studies. This study shows that dynamic contrast-enhanced magnetic resonance imaging identifies various adaptive responses of the liver microvasculature in islet transplant recipients and that these responses might have an impact on islet engraftment.

KW - DCE-MRI

KW - liver microvascular changes

KW - pancreatic islet transplantation

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