Reduction of ischemia/reperfusion injury by antithrombin III after experimental pancreas transplantation.
BACKGROUND
Graft pancreatitis is a major complication after pancreas transplantation. Antithrombin III (AT III) is an anticoagulatory and anti-inflammatory substance. The aim of our study was to evaluate a prophylactic application of AT III in experimental pancreas transplantation.


METHODS
Pancreas transplantation was performed in rats. Cold ischemia time (University of Wisconsin solution at 4 degrees C) was 12 hours. After 4 hours of reperfusion, pancreatic enzymes were assessed and the pancreas was evaluated by intravital microscopy and histologic and immunohistochemical examination. Recipients were allocated randomly to 2 groups: 1 control group (n = 6) and 1 group in which recipients received 125 IU AT III/kg 30 minutes before reperfusion (n = 6). Six animals that did not undergo transplantation served as healthy controls.


RESULTS
Enzyme levels showed no differences between the 2 transplantation groups but were significantly (P <.05) higher than in the control group. Histologic damage was significantly less evident in animals that received AT III compared with transplantation animals that did not receive AT III. During intravital microscopy, animals receiving AT III showed significantly higher capillary and venular erythrocyte velocities compared with untreated transplantation animals. The leukocyte-endothelium interaction in postcapillary venules was decreased significantly in animals with AT III treatment.


CONCLUSIONS
AT III pretreatment decreases tissue damage by attenuating microcirculatory disturbances and leukocyte adherence in experimental graft pancreatitis by its anti-inflammatory and anticoagulatory properties.
Hackert
Thilo
T
Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Thilo_Hackert@med.uni-heidelberg.de
Werner
Jens
J
Uhl
Waldemar
W
Gebhard
Martha-Maria
MM
Büchler
Markus W
MW
Schmidt
Jan
J
D000681:Amylases / Q000097:blood; D000818:Animals; D000990:Antithrombin III / Q000627:therapeutic use*; D007150:Immunohistochemistry; D008049:Lipase / Q000097:blood; D008297:Male; D008833:Microcirculation; D010179:Pancreas / Q000473:pathology; D016035:Pancreas Transplantation; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control*; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*
D015842:Serine Proteinase Inhibitors; D000990:Antithrombin III; D008049:Lipase; D000681:Amylases