Massimo Venturini MD, Presenter: Nothing to Disclose

Paola Maffi, Abstract Co-Author: Nothing to Disclose

Claudio Losio MD, Abstract Co-Author: Nothing to Disclose

Paolo Fiorina, Abstract Co-Author: Nothing to Disclose

Antonio Secchi, Abstract Co-Author: Nothing to Disclose

Alessandro Del Maschio MD, Abstract Co-Author: Nothing to Disclose

In type 1 diabetes, percutaneous intraportal islet transplantation represents a less invasive alternative to pancreas transplantation. Few longitudinal imaging studies of liver-engrafted islets are available for islet-transplant-alone (ITA) and islet-after-kidney (IAK) transplanted patients. Particularly the link between islet function and the appearance of islet-induced LFFC-US is controversial. Aims of this study were to assess prospectively LFFC-US after islet transplantation and their relationship of with islet function.

LFFC-US timing of first detection, its prevalence, and duration were assessed in 30 IAK transplanted patients, in 5 ITA patients and, retrospectively, in full-, partial-, and no-function groups, according to islet function evaluated one year after islet transplantation. Patients with persistent LFFC-US underwent liver biopsy. LFFC-US-positive and LFFC-US-negative patients with functioning-islets were compared for islet function and C-peptide-levels during the follow-up. Variation of cholesterol/triglycerides and other metabolic parameters were also recorded at one year.

LFFC-US were found in 12 patients (10/30 IAK, 2/5 ITA). First detection was at 6 months in 8 cases, at 12 months in 4 cases. LFFC-US last longer than 1 year in 8 cases. Steatosis was found histologically in 8/8 patients. At 12 months, LFFC-US were detected to a higher extent in patients with partial-islet-function (10/12, 8 IAK, 2 ITA) compared to patients with full-islet-function. C-peptide-levels were significantly lower in LFFC-US-positive than in LFFC-US-negative patients. At 18 months, LFFC-US-positive were more prone to worsen their function (9/12) compared to LFFC-US negative patients (3/18). No statistically significant differences of cholesterol/triglycerides levels were found in total, IAK and ITA patients.

US after islet transplantation represents a sensitive tool to diagnose/monitor LFFC-US, resulting more related to partial than full islet function, in both IAK and ITA patients. We could suppose that in case of full-function the local insulin secretion is not enough to induce steatosis. Differently, in some cases of partial-function, steatosis could be the expression of some remaining vital islets stressed in insulin overproduction due to lost function of other islets.

Steatosis after islet transplantation may represent an early sign of altered graft-function.

Venturini, M, Maffi, P, Losio, C, Fiorina, P, Secchi, A, Del Maschio, A, Liver Focal Fatty Changes at Ultrasound (LFFC-US) after Islet Transplantation: An Early Sign of Altered Graft Function?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9015121.html