A novel model for in vivo quantification of immediate liver perfusion impairment after pancreatic islet transplantation

Islets. 2019;11(6):129-140. doi: 10.1080/19382014.2019.1651164. Epub 2019 Sep 9.

Abstract

Instant Blood-Mediated Inflammatory Reaction (IBMIR) is a major cause of graft loss during pancreatic islet transplantation, leading to a low efficiency of this treatment method and significantly limiting its broader clinical use. Within the procedure, transplanted islets obstruct intrahepatic portal vein branches and consequently restrict blood supply of downstream lying liver tissue, resulting typically in ischemic necrosis. The extent of ischemic lesions is influenced by mechanical obstruction and inflammation, as well as subsequent recanalization and regeneration capacity of recipient liver tissue. Monitoring of immediate liver perfusion impairment, which is directly related to the intensity of post-transplant inflammation and thrombosis (IBMIR), is essential for improving therapeutic and preventive strategies to improve overall islet graft survival. In this study, we present a new experimental model enabling direct quantification of liver perfusion impairment after pancreatic islet transplantation using ligation of hepatic arteries followed by contrast-enhanced magnetic resonance imaging (MRI). The ligation of hepatic arteries prevents the contrast agent from circumventing the portal vein obstruction and enables to discriminate between well-perfused and non-perfused liver tissue. Here we demonstrate that the extent of liver ischemia reliably reflects the number of transplanted islets. This model represents a useful tool for in vivo monitoring of biological effect of IBMIR-alleviating interventions as well as other experiments related to liver ischemia. This technical paper introduces a novel technique and its first application in experimental animals.

Keywords: IBMIR; MRI; Pancreatic islet transplantation; instant blood-mediated inflammatory reaction; liver ischemia; magnetic resonance imaging.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Embolism* / complications
  • Embolism* / diagnosis
  • Graft Survival
  • Image Enhancement / methods
  • Ischemia* / diagnostic imaging
  • Ischemia* / etiology
  • Islets of Langerhans Transplantation / adverse effects*
  • Liver* / blood supply
  • Liver* / diagnostic imaging
  • Liver* / pathology
  • Magnetic Resonance Angiography / methods*
  • Models, Theoretical
  • Portal Vein*
  • Rats
  • Reproducibility of Results

Grants and funding

The project was supported by the Czech Science Foundation under Grant # 14-03305S; and Ministry of Health of the Czech Republic under Grant # 16-28249A and # 16-28254A.