[Whole pancreatic transplantation and islet transplantation. Experiment notes].
BACKGROUND
The results of pancreas transplantation have greatly improved in recent years. The path to further improvements goes through extensive experimental researches.


METHODS
This study describes the effects of different procedures as hemodynamic asset and postoperative outcome. Twenty-nine swine underwent a total pancreatectomy, and were stratified into five groups. Group one (n = 5) served as control. Group two (n = 7) was autotransplanted. Group three (n = 6) and group four (n = 6) underwent allotransplantation; the first without immunosuppression and the second treated with cyclosporine and steroids. In group five (n = 5) Langerhans Islets transplantation was performed.


RESULTS
Survival was different depending on which methodology was applied. The postoperative survival was 7 +/- 2 days in group one, 24 +/- 16 days in group two, 17 +/- 7 days in group three, 27 +/- 8 days in group four and 12 +/- 6 days in group five.


CONCLUSIONS
The postoperative glucose control was normal in group two and group four while a severe diabetes appeared in group one (group 1 vs group 2: p < 0.05) and in group three during acute graft rejection after the 12th postoperative day (group 3 vs group 4: p < 0.05). Glycemia was slightly controlled in group five. The intraoperative hemodynamic status was evaluated at the time of pancreatectomy, harvesting, revascularization, and when surgery was over. Among the different parameters studied (mean arterial and pulmonary pressure, pulmonary wedge pressure, central venous pressure, cardiac output, oxygen extraction ratio, systemic vascular resistance, oxygen delivery and oxygen consumption), a statistically significant difference between group one and group five (p < 0.05) was observed.
Luzzana
F
F
Dipartimento di Chirurgia, Università degli Studi, Pavia.
Gaspari
A
A
Rademacher
J
J
Adams
G
G
Passalia
L
L
Matteotti
C
C
Innocente
F
F
Polese
M
M
Dionigi
P
P
Zonta
A
A
Maestri
M
M
D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D003921:Diabetes Mellitus, Experimental / Q000401:mortality / Q000601:surgery*; D005260:Female; D006439:Hemodynamics; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation / Q000401:mortality; D008962:Models, Theoretical; D016035:Pancreas Transplantation / Q000401:mortality; D010180:Pancreatectomy; D012092:Replantation; D013552:Swine; D013997:Time Factors
D001786:Blood Glucose; D007166:Immunosuppressive Agents