Autogenous transplantation of a duct ligated pancreas: a functional and histological study

Abstract

Context: The use of foetal tissue is an emotive issue and attempts are being made to find suitable alternative replacements. A duct ligated pancreas resembles day 16-17 post-coitum foetal pancreas tissue, both being predominantly endocrine structures.

Objective: The aim of this study was to quantify the metabolic changes occurring in chemically induced diabetic rats over a 30 day period following transplantation of duct ligated tissue beneath the renal capsule.

Setting: Thirty normal Sprague-Dawley laboratory rats.

Design: The rats were grouped as transplant recipients (A), untreated diabetic (B), untreated normal (C), sham operated controls (D) and donors of duct ligated pancreatic tissue (E).

Interventions: Groups A and B received 60 mg/kg streptozotocin via a tail vein rendering them diabetic. Groups D and E underwent mid-line laparotomy under general anaesthesia with pancreatic duct ligation procedures performed on E in addition.

Main outcome measures: Blood glucose was monitored daily in Groups A, B, C and D, and exogenous insulin was administered in Groups A and B as required. Glucose tolerance tests were performed on day 3.5 and after 30 days in Groups A (just prior to unilateral nephrectomy), B, C and D. In addition, in Group A, they were repeated one week after the removal of the grafted tissue. The removed grafts were processed for histological examination.

Results: The metabolic profile of the transplant recipients compared favourably with that of normal animals.

Conclusion: A chemically or mechanically manipulated pancreas may respond to exogenous insulin therapy by undergoing some degree of regeneration or owing to the pluripotent stem cells thought to reside in the pancreas. Although insulin positive tissue was evident at the graft site, morphometric assessment, however, found no significant increase in the insulin secreting tissue in the pancreas compared to the untreated diabetic controls.