Portal Flow Dynamics after Total Pancreatectomy and Autologous Islet Cell Transplantation.

BACKGROUND Portal vein thrombosis (PVT) is a serious complication of total pancreatectomy and autologous islet cell transplant (TPAIT), therefore, portal flow dynamics are monitored by doppler ultrasound postoperatively. The practical value of scheduled doppler ultrasound examinations and the relationship between portal vein velocity, liver function, and complications has not been clearly studied. METHODS Retrospective review of 16 TPAIT was performed. Correlation analysis of portal vein velocity with indices of liver function, portal pressure, and volume of islet cells infused was conducted. RESULTS There was no correlation between portal vein velocity and postoperative liver function tests (LFTs). Larger volume of islet cells infused and higher intraoperative portal pressure correlated with decreased postoperative portal flow. There was no significant difference in portal pressure, portal vein velocity, or LFTs between those with normal and abnormal pre-infusion liver histopathology. While no PVT occurred, there were two cases of postoperative bleeding related to anticoagulation. CONCLUSION Segmental portal vein velocities are low in the setting of high tissue volume and portal pressure, but are not associated with variation in LFTs. Therefore, repeat US in response to changes in LFTs without clinical symptoms may be unnecessary.