Studies on segmental pancreatic autotransplants in dogs
R. Munda, Y. Berlatzky, M. Jonung, R. F. Murphy, K. Brackett, S. N. Joffe and J. W. Alexander
Success with segmental pancreas transplants has been impaired by
immunologic and technical considerations. Experiments were performed with
autotransplants to avoid immunologic problems, allowing concentration on
surgical techniques. Survival of splenic lobe pancreas autotransplants in
pancreatectomized dogs was extended with relocation of the graft from the
groin to the abdominal cavity and distal arteriovenous fistula to increase
graft flow. Fibrosis of the graft occurred regardless of the method of duct
treatment, latex (Neoprene) or Silastic injection or free intraperitoneal
drainage. Hormonal responses in normoglycemic animals showed normal insulin
levels (6 +/- 0.8 microU/mL) as compared with controls (5.4 +/- 0.9
microU/mL), while peak levels during arginine stimulation were higher in
dogs with autotransplants (39.7 +/- 20 microU/mL) than in controls (15.1
+/- 1.9 microU/mL. Pancreatic polypeptide basal levels in animals with
transplants were 42 +/- 2.2 pg/mL as compared with 256 +/- 28 pg/mL in
controls, with no response to bombesin or protein meal stimulation. In this
model, splenic lobe was capable of maintaining normoglycemia with avoidance
of ketogenic amino acid patterns. Continuous fibrosis was the biggest
threat to islet survival.