Secondary failure of islets autotransplantation in totally pancreatectomized dogs: a multifactorial study.

Even without any immunologic barrier, as in autografts, reversal of diabetes induced by islets transplantation is not definitive and a secondary failure generally occurs. Factors involved in this failure were investigated in 13 male dogs undergoing total pancreatectomy and extemporaneous islets reinjection in the portal circulation. Five dogs died from postoperatory complications, three remained diabetic, and five were normoglycemic without insulin therapy for a duration of two to 26 weeks. Factors associated with failure appeared to be: (a) hemorrhage during dissection of pancreas prior to islets isolation, (b) imperfect collagenase digestion. Moreover, duration of this period of normoglycemia was negatively correlated with glycemia on the 20th postoperatory hour (r = 0.759, p less than 0.05), suggesting a possible relationship between glycemia and further graft outcome. Therefore, such a multifactorial statistical analysis seems to be helpful for the study of multiple technical parameters associated with the prognosis of islets transplantations.