ORIGINAL ARTICLES   

Minerva Chirurgica 1999 June;54(6):375-88

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

Whole graft transplantation and the isolated islets approach. Experimental notes

Luzzana F., Gaspari A., Rademacher J., Adams G., Passalia L., Matteotti C., Innocente F., Polese M., Dionigi P., Zonta A., Maestri M.

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 allotrasplantation; 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 post-operative 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 post-operative day (group 3 vs group 4: p<0.05). Glicemya 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.