INTRODUCTION: The liver is the primary target location for islet infusion and portal vein catheterization is generally used.

BACKGROUND: Current islet infusion approach via portal vein of liver has various defects. The aim of this work is to investigate the feasibility and safety of an indwelling catheter in the umbilical vein for intra-portal islet transplantation.

PATIENTS AND METHODS: Twelve patients with type 1 diabetes mellitus were generally anesthetized and incised in the middle-right of upper abdomen. The umbilical vein was identified, dissected and catheterized. The catheter was located in trunk of portal vein, and the islet suspension was infused. After surgery the catheter was secured to skin for optional subsequent infusions and flushed with heparinized saline once per day within one month post-operation. The catheter was removed after one month post-operation. The therapeutic effects and peri-operation complications were observed.

RESULTS: All patients successfully underwent catheterization and transplantation. Insulin independence was finally achieved in 75% (9/12) patients at 1 year post-operation; seven patients received a second infusion. The mean surgical duration was 58.5±10.3 minutes, the mean incision length was 7.6 ± 0.9 cm, and the estimated hemorrhage volume was 52.5±13.6 mL. No significant change in portal pressure was observed (before infusion 3.8±2.0 cm H₂O, after infusion 3.4±1.9 cm H₂O, p>0.05). Neither infection nor severe hemorrhage was found after surgery.

DISCUSSION: The umbilical vein approach is easy to conduct and avoids digestive side effects, allowing a second islet infusion through the indwelling catheter.

CONCLUSIONS: It is feasible, convenient, and safe to use an indwelling catheter in the umbilical vein for islet transplantation.