Pig pancreas anatomy: implications for pancreas procurement, preservation, and islet isolation.
BACKGROUND
Islet transplantation is emerging as a treatment option for selected patients with type 1 diabetes. The limited human islet supply from cadavers and poor islet yield and quality remain substantial impediments to progress in the field. Use of porcine islets holds great promise for large-scale application of islet transplantation. Consistent isolation of porcine islets is dependent on advances in pancreas procurement, pancreas preservation, and islet isolation, requiring detailed knowledge of the porcine pancreatic anatomy. The primary aim of this study was to describe the vascular and ductal anatomy of the porcine pancreas to guide and improve organ preservation and enzyme perfusion.


METHODS
Pancreata were removed by en bloc viscerectomy from 65 female Landrace pigs.


RESULTS
Fifteen percentage of organs exhibited inconsistent vascular branching from the celiac trunk. All organs showed uniform patterns of branching at the superior mesenteric artery. The superior and inferior mesenteric veins merged to become the portal vein in all but one case in which the inferior mesenteric vein drained into the splenic vein. Ninety-seven percent of pancreata had three lobes: duodenal lobe (DL), connecting lobe (CL), and splenic lobe (SL); 39% demonstrated ductal communication between the CL and the other two lobes; 50% had ductal communication only between the CL and duodenal lobe; and 11% presented other types of ductal delineation.


CONCLUSIONS
Accounting for the variations in vascular and ductal anatomy, as detailed in this study, will facilitate development of protocols for preservation, optimal enzyme administration, and pancreas distention and digestion, and will ultimately lead to substantial improvements in isolation outcomes.
Ferrer
Joana
J
Department of Surgery, Diabetes Institute for Immunology and Transplantation, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
Scott
William E
WE
Weegman
Bradley P
BP
Suszynski
Thomas M
TM
Sutherland
David E R
DE
Hering
Bernhard J
BJ
Papas
Klearchos K
KK
D000818:Animals; D005260:Female; D007515:Islets of Langerhans / Q000033:anatomy & histology* / Q000098:blood supply / Q000473:pathology; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D008953:Models, Anatomic; D023421:Models, Animal; D019188:Organ Preservation Solutions; D010179:Pancreas / Q000033:anatomy & histology* / Q000098:blood supply / Q000473:pathology; D016035:Pancreas Transplantation / Q000379:methods*; D010477:Perfusion; D011309:Preservation, Biological; D013048:Specimen Handling; D013162:Splenic Vein / Q000473:pathology; D013552:Swine; D016896:Treatment Outcome
D019188:Organ Preservation Solutions