Portal hypertension, hepatic infarction, and liver failure complicating pancreatic islet autotransplantation

A patient with chronic pancreatitis who underwent subtotal pancreatectomy and pancreatic islet tissue autotransplantation by portal vein embolization developed marked portal hypertension requiring surgical portal systemic decompression. The patient subsequently developed extensive hepatic infarction and died of liver failure. Postmortem studies showed organizing thromboemboli containing pancreatic acinar and islet tissue in the intrahepatic portal venous radicles and widespread ischemic infarcts with periportal sparing. Factors contributing to hepatic infarction were thrombosis of portal venous radicles, portasystemic shunting, and systemic arterial hypotension. Marked portal hypertension, hepatic infarction, and liver failure are potential complications of pancreatic islet tissue autotransplantation.