Disseminated periportal fatty degeneration after allogeneic intraportal islet transplantation in a patient with type 1 diabetes mellitus: a case report.

摘要: Insulin independence after islet transplantation has been significantly improved by using new steroid-free immunosuppressive protocols and increased mass. Only little is known about the influence on morphology of liver intraportally transplanted islets. We describe a case disseminated periportal fatty degeneration allogeneic intraportal (ITx). A 35-year-old patient with type-1 diabetes mellitus who was suffering from repeated severe hypoglycemic episodes received two sequential grafts. Liver structure normal before first ITx, based upon ultrasound magnetic resonance imaging (MRI). One week demonstrated morphology. Four months later, at second we detected small, disseminated, hypodense hepatic lesions (1 to 3 mm) ultrasound, which were confirmed MRI interpreted be degenerations. Histologically found focal drop-shaped degenerations signs mild chronic inflammation. These alterations without clinical symptoms or pathological function tests matched predicted distribution infused Glucose metabolism markedly namely 58.6% reduction daily insulin requirements, 1.4% decrease in HbA1c, basal C-peptide 0.8 1.3 ng/dl no hypoglycemia. these benign changes as reactions local hyperinsulinemia neighborhood hypothesized that immunosuppression rapamycin tacrolimus may have contributed portal microenvironment.