Objective To explore the safety and efficacy of islet cell transplantation through percutaneous trans-hepatic puncture of portal vein for treating type 1 diabetes on pediatric liver transplantation recipients. Methods The clinical data of one type 1 diabetic child undergoing islet cell transplantation after liver transplantation in Tianjin First Central Hospital was analyzed retrospectively. The donor pancreas was digested by injecting collagenase solution combined with neutral protease and the islets were purified using continuous density gradients centrifugation. Cultured islets were infused through percutaneous trans-hepatic portal vein puncture to the liver of a pediatric patient with type 1 diabetes after liver transplantation in Tianjin first center hospital. Theblood glucose，insulin dosage，C-peptide，liver and renal function after transplantation were monitored. After transplantation, the patient was treated with anti-rejection and anticoagulation therapy, the insulin was used according to the blood glucose. Results The yield of high purity islet was 212 073 islet equivalents（IEQ）. Islet viability was 95% while the glucose stimulation index（GSI）was 1.77. The transplant tissue volume was 1 ml. After islet transplantation，the fasting blood glucose of the child patient became stable gradually, and the daily insulin dosage gradually decreased. Exogenous insulin therapy was completely stopped 20 d post islet transplantation with normal fasting C-peptide levels. The patient's liver and renal function was stable while no complications after islet transplantation was observed. Conclusion The islet transplantation is effective and safe for treating children with type 1 diabetes after liver transplantation.

目的 探讨肝移植后患儿行经皮经肝门静脉穿刺胰岛细胞移植，治疗 1 型糖尿病的安全性与 有效性。方法 回顾性分析天津市第一中心医院 1 例肝移植后进行胰岛细胞移植的 1 型糖尿病患儿的临床 资料。利用胶原酶联合中性蛋白酶消化捐赠者胰腺，连续密度梯度离心方法纯化胰岛细胞。患儿全麻下行 经皮经肝门静脉穿刺胰岛移植术，将胰岛细胞经门静脉移植到肝脏内。术后监测血糖、胰岛素用量、C 肽 与肝肾功能。移植后给予防治排斥反应、抗凝、预防感染治疗，根据患儿血糖酌情给予胰岛素。结果 成 功分离高纯度胰岛，胰岛当量为 212 073 IEQ，活性 95%，葡萄糖刺激指数为 1.77，组织量为 1 ml。术后患 儿空腹血糖日趋平稳，每日胰岛素用量逐渐降低，移植后 20 d 完全停用外源性胰岛素，空腹 C 肽水平显著 升高，肝肾功能稳定，无胰岛移植并发症。结论 儿童肝移植后胰岛细胞移植治疗 1 型糖尿病疗效良好， 安全性高。