Desai CS, Khan KM, Cui W. Islet autotransplantation in a patient with hypercoagulable disorder. World J Transplant 2016; 6(2): 437-441 [PMID: 27358790 DOI: 10.5500/wjt.v6.i2.437]
Corresponding Author of This Article
Chirag S Desai, MD, Associate Professor of Surgery, Medstar Georgetown Transplant Institute, 3800 Reservoir Road, NW, Washington, DC 20007, United States. chirag.s.desai@gunet.georgetown.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Jun 24, 2016; 6(2): 437-441 Published online Jun 24, 2016. doi: 10.5500/wjt.v6.i2.437
Islet autotransplantation in a patient with hypercoagulable disorder
Chirag S Desai, Khalid M Khan, Wanxing Cui
Chirag S Desai, Khalid M Khan, Wanxing Cui, Medstar Georgetown Transplant Institute, Washington, DC 20007, United States
Author contributions: Desai CS designed the research, performed research, gathered data, wrote paper; Khan KM wrote paper, did critical revision of manuscript, and contributed to ideas; Cui W gathered data, structured manuscript and help writing paper.
Institutional review board statement: This study is under IRB approved protocol (ID: 2015-1379) of Georgetown University.
Informed consent statement: This study is under IRB approved protocol (ID: 2015-1379) for de-identified patient information.
Conflict-of-interest statement: The authors have no potential conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chirag S Desai, MD, Associate Professor of Surgery, Medstar Georgetown Transplant Institute, 3800 Reservoir Road, NW, Washington, DC 20007, United States. chirag.s.desai@gunet.georgetown.edu
Telephone: +1-202-4447287 Fax: +1-202-4446473
Received: February 3, 2016 Peer-review started: February 14, 2016 First decision: March 1, 2016 Revised: April 4, 2016 Accepted: April 21, 2016 Article in press: April 22, 2016 Published online: June 24, 2016 Processing time: 140 Days and 12.6 Hours
Abstract
Total pancreatectomy and islet auto transplantation is a good option for chronic pancreatitis patients who suffer from significant pain, poor quality of life, and the potential of type 3C diabetes and pancreatic cancer. Portal vein thrombosis is the most feared complication of the surgery and chances are increased if the patient has a hypercoagulable disorder. We present a challenging case of islet auto transplantation from our institution. A 29-year-old woman with plasminogen activator inhibitor-4G/4G variant and a clinical history of venous thrombosis was successfully managed with a precise peri- and post-operative anticoagulation protocol. In this paper we discuss the anti-coagulation protocol for safely and successfully caring out islet transplantation and associated risks and benefits.
Core tip: Total pancreatectomy and islet auto-transplantation is an option for select patients with chronic pancreatitis. Portal vein thrombosis is the most feared surgical complication and chances are increased if the patient has a hypercoagulable disorder. The paper describes important topics like the management of the anticoagulation in the peri-operative period.
