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.