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BACKGROUND:Pig islet xenotransplantation has the potential to overcome the shortage of donated human islets for islet cell transplantation in type 1 diabetes.Testing in non-human primate models is necessary before clinical application in humans.Intraportal islet transplantation in ms is usually performed by surgical infusion during laparotomy or laparoscopy.In this paper,we describe a new method of percutaneous transhepatic portal catheterization(PTPC)as an alternative to current methods of islet transplantation in rhesus ms.METHODS:We performed ultrasound-guided PTPC in five adult rhesus ms weighing 7-8 kg,with portal vein catheterization confirmed by digital subtraction angiography.We monitored for complications in the thoracic and abdominal cavity.To evaluate the safety of ultrasound-guided PTPC,we recorded the changes in portal pressure throughout the microbead transplantation procedure.RESULTS:Ultrasound-guided PTPC and infusion of 16 000 microbeads/kg body weight into the portal vein was successful in all five ms.Differences in the hepatobiliary anatomy of rhesus ms compared to humans led to a higher initial complication rate.The first m died of abdominal hemorrhage 10 hours post-transplantation.The second suffered from a mild pneumothorax but recovered fully after taking only conservative measures.After gaining experience with the first two ms,we decreased both the hepatic puncture time and the number of puncture attempts required,with the remaining three ms experiencing no complications.Portal pressures initially increased proportional to the number of transplanted microbeads but returned to preinfusion levels at 30 minutes post-transplantation.The changes in portal pressures occurring during the procedure were not significantly different.CONCLUSIONS:Ultrasound-guided PTPC is an effective,convenient,and minimally invasive method suitable for use in nonhuman primate models of islet cell transplantation provided that care is taken with hepatic puncture.Its advantages must be weighed against the risks of procedure-related complications.