Studies on the duct-ligated pancreas as allograft for islet cell function

Abstract

Twenty previously pancreatectomized dogs were heterotopically transplanted with duct-ligated allografts. Sixteen of the grafts were preserved for 24 hours, nine with continuous hypothermic albumin perfusion, seven with hypothermic storage. Five dogs died from early postoperative bleedings. Fifteen surviving dogs had a satisfying endocrine function assessed by blood glucose and serum insulin during fasting and after glucose load. In six dogs the glucagon release from the graft was investigated and significant release was evident in all dogs. A high release was found after L-arginine stimulation. The endocrine function was satisfying after 24 hour preservation both with hypothermic storage and continuous hypothermic albumin perfusion. During such perfusion the pancreas became very oedematous. This did not influence on the outcome of the transplantation. The grafts were enlarged four to eight days after transplantation. Oedema, fibrotic changes and collagen depositions in the interstitial tissue were observed in light microscopy. These changes seemed to come earlier in glands preserved for 24 hours. Islet cells were identified in all functioning grafts and seemed histopathologically and ultrastructurally unchanged. A duct-ligated pancreatic segment was allografted to one diabetic patient in a pilot experiment. There was a satisfying endocrine function for 40 days. After that the graft became necrotic due to thrombus formation.