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Positron Emission Tomography in Clinical Islet Transplantation |
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| Authors: | O Eriksson T Eich A Sundin A Tibell G Tufveson H Andersson M Felldin A Foss L Kyllönen B Langstrom B Nilsson O Korsgren T Lundgren |
| Institution: | 1. Department of Radiology, Oncology and Clinical Immunology, Division of Radiology, University Hospital;2. Uppsala Imanet, GE Healthcare;3. Department of Radiology, Oncology and Clinical Immunology, Division of Clinical Immunology, University Hospital;4. Department of Radiology, Karolinska University Hospital, Stockholm and Uppsala University Hospital, Uppsala, Sweden;5. Division of Transplantation Surgery, CLINTEC, Karolinska Institute, Stockholm, Sweden;6. Department of Surgical Sciences, Division of Transplantation Surgery, University Hospital, Uppsala, Sweden;7. Department of Nephrology and Transplantation, University Hospital, Malm?, Sweden;8. Department of Transplantation, University Hospital, Gothenburg, Sweden;9. Department of Transplantation Surgery, Rikshospitalet‐Radiumhospitalet Medical Center, Oslo, Norway;10. Division of Transplantation, Surgical Hospital, Helsinki University, Helsinki, Finland;11. Department of Biochemistry and Organic Chemistry, Uppsala University, Uppsala, Sweden |
| Abstract: | The fate of islets in clinical transplantation is unclear. To elude on this positron emission tomography combined with computed tomography (PET/CT) was performed for 60 min during islet transplantation in five patients receiving six transplants. A fraction of the islets (23%) were labeled with 18F‐fluorodeoxyglucose (18F]FDG) and carefully mixed with unlabeled islets just prior to intraportal transplantation. The peak radioactivity concentration in the liver was found at 19 min after start of islet infusion and corresponded to only 75% of what was expected, indicating that islets are lost during the transplantation procedure. No accumulation of radioactivity was found in the lungs. A nonphysiological peak of C‐peptide was found in plasma during and immediately after transplantation in all subjects. Distribution in the liver was heterogeneous with wide variations in location and concentration. Islets found in areas with concentrations of >400 IEQ/cc liver tissue varied between 1% and 32% of the graft in different subjects. No side effects attributed to the PET/CT procedure were found. Clinical outcome in all patients was comparable to that previously observed indicating that the 18F]FDG labeling procedure did not harm the islets. The technique has potential to be used to assess approaches to enhance islet survival and engraftment in clinical transplantation. |
| Keywords: | Clinical islet transplantation positron emission tomography (PET) 18F‐fluorodeoxyglucose ([18F]FDG) instant blood‐mediated inflammatory reaction (IBMIR) |