title: Back to the reinnervation of the pancreas after transplantation? (Experimental study on dogs, cats, and rats).
abstract: BACKGROUND
  Significant functional decrease and sclerosis of the pancreas graft in late delays cannot only be related to chronic rejection. Any transplantation leads to graft denervation, which may be an important cause of dysfunction. Studies concerning graft reinnervation were controversial.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the feasibility and pertinence of a surgically directed reinnervation (SDR) of denervated/neuro-reflex isolated (NRI) or autotransplanted (aTx) pancreas.
  
  
  METHODS
  Anatomy of the nerves penetrating into the pancreas was studied in humans, dogs, cats, and rats. Surgery and physiological investigations were performed in dogs, cats, and rats. Nervous conductivity between NRI, NRI+SDR pancreas, and brain was tested. Load tests with glucose, insulin, and adrenalin were performed; amylase and lipase were determined in fasted and not fasted animals to evaluate the influence of NRI and SDR on pancreatic function. Histology was provided. Observation delays were 6 months.
  
  
  RESULTS
  Anatomic feasibility of SDR in humans and animals was proved. Models of pancreatic tail NRI and surgical reconstitution of the interrupted nervous pathways (SDR) were elaborated in animals. The restoration of the pancreas-brain reflex axis after SDR was electro physiologically proved. As blood glucose curves after load test, exocrine amylase and lipase determination have shown that pancreas NRI or aTx leads to an exaggerated reaction to usual stimulations that may cause the observed graft functional exhaustion in late delays. SDR shortened the period of the graft neuro-reflex isolation, contributed to a quick normalization of its function, and prevented its late degradation.
  
  
  CONCLUSIONS
  SDR was shown to be a simple surgical technique, easily performed after the graft surgical revascularization. Its functional and morphological efficiency was tested and proved. Thus, SDR may be recommended in human pancreas transplantation as pertinent.
authors.affiliation: Digestive Surgery Unit, Hopital Erasme, Brussels, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Mikhalski
authors.affiliation: Laboratory of Experimental Medicine, Université Libre de Bruxelles, Centre Hospitalier Universitaire, Brugmann site Horta, Brussels, Belgium. Electronic address: coulic.very@belgacom.net.
authors.forename: V
authors.initials: V
authors.lastname: Coulic
authors.affiliation: Neurophysiology Department, People Friendship University, Moscow, Russian Federation.
authors.forename: D
authors.initials: D
authors.lastname: Bilibin
authors.affiliation: Central Institute of Emergencies, Moscow, Russian Federation.
authors.forename: V
authors.initials: V
authors.lastname: Novikov
authors.affiliation: Institut de Pathologie et de Génétique, Gosselies, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Delrée
mesh_terms: D000681:Amylases / Q000097:blood; D000818:Animals; D064592:Autografts / Q000294:innervation* / Q000378:metabolism / Q000473:pathology; D001786:Blood Glucose / Q000378:metabolism; D002102:Cadaver; D002415:Cats; D003714:Denervation; D004210:Dissection; D004285:Dogs; D005240:Feasibility Studies; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008049:Lipase / Q000097:blood; D010179:Pancreas / Q000294:innervation* / Q000378:metabolism / Q000473:pathology; D016035:Pancreas Transplantation; D051381:Rats; D014182:Transplantation, Autologous
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008049:Lipase; D000681:Amylases