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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肝脏机器灌注过程中门静脉内胰岛植入的第一例，允许人体同时进行胰岛-肝脏移植：一种治疗终末期肝病合并糖尿病的新的安全疗法。


目的 评估将胰岛移植物肝脏植入终末期肝病和糖尿病 (DM) 患者的安全性和有效性。背景技术糖尿病和终末期肝病是世界范围内重大的健康问题，常常共存且相互影响。同时解决这两种疾病至关重要。方法采用胰岛移植联合无缺血肝移植（ITIFLT）技术治疗肝细胞癌（HCC）合并2型糖尿病（T2DM）患者。采用无缺血肝移植（IFLT）技术获取并保存肝脏，并在常温机器灌注（NMP）过程中，将分离纯化的胰岛移植物通过门静脉移植到肝脏中。最后，肝脏与移植的胰岛移植物一起在不中断血液供应的情况下被植入受体体内。结果 患者接受了同一供体的肝脏和胰岛移植物。患者在移植后第 9 天 (PTD) 就实现了胰岛素独立，肝脏和胰岛功能仍然强劲。患者于 PTD 18 日出院，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案例标志着 ITIFLT 在人类中的首次应用，表明其作为治疗 DM 终末期肝病的有前途的治疗方式的潜力。