OBJECTIVE Evaluating the safety and efficacy of implanting a liver with islet grafts into patients with end-stage liver disease and diabetes mellitus (DM). BACKGROUND DM and end-stage liver diseases are significant health concern worldwide, often coexisting and mutually influencing each other. Addressing both diseases simultaneously is paramount. METHODS We utilized the islet transplantation combined ischemia-free liver transplantation (ITIFLT) technique to treat a patient with hepatocellular carcinoma (HCC) and type 2 diabetes mellitus (T2DM). The liver was procured and preserved using the ischemia-free liver transplantation (IFLT) technique, and during normothermic machine perfusion (NMP), isolated and purified islet grafts were transplanted into the liver through the portal vein. Finally, the liver, incorporating with the transplant islet grafts, was implanted into the recipient without interruption of blood supply. RESULTS The patient received both liver and islet graft from the same donor. The patient achieved insulin-independence by post-transplant day (PTD) 9, and both liver and islet function remained robust. The patient was discharged on PTD 18 and experienced no surgical or transplantation-related complications during the follow-up period. Furthermore, islet grafts presence was observed in liver biopsies after islet transplantation. CONCLUSIONS This landmark case marks the inaugural application of ITIFLT in humans, signifying its potential as a promising treatment modality for end-stage liver disease with DM.

中文翻译：

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第一例在肝脏机器灌注期间门静脉内胰岛植入允许人类胰岛-肝脏同步移植的病例：一种针对终末期肝病合并糖尿病的新型安全治疗方法。


目的 评价胰岛移植肝脏植入终末期肝病合并糖尿病 （DM） 患者的安全性和有效性。背景 DM 和终末期肝病是世界范围内重要的健康问题，通常共存并相互影响。同时解决这两种疾病至关重要。方法 我们利用胰岛移植联合无缺血肝移植 （ITIFLT） 技术治疗肝细胞癌 （HCC） 和 2 型糖尿病 （T2DM） 患者。使用无缺血肝移植 （IFLT） 技术获取和保存肝脏，在常温机器灌注 （NMP） 期间，分离和纯化的胰岛移植物通过门静脉移植到肝脏中。最后，将肝脏与移植胰岛移植物结合，在不中断血液供应的情况下植入受者体内。结果 患者接受了来自同一供体的肝脏和胰岛移植物。患者在移植后第 9 天 （PTD） 时实现了胰岛素独立性，肝脏和胰岛功能保持稳健。患者于 PTD 18 出院，在随访期间未出现手术或移植相关并发症。此外，在胰岛移植后的肝活检中观察到胰岛移植物的存在。结论 这一具有里程碑意义的病例标志着 ITIFLT 在人体中的首次应用，标志着其作为 DM 终末期肝病治疗方式的潜力。