Du Toit D F, Heydenrych J, Smit B, van der Merwe E, Louw G, Zuurmond T, Els D, Weideman A, Du Toit L, Wolfe-Coote S
Department of Surgery, University of Stellenbosch Medical School, Tygerberg, South Africa.
J Surg Oncol. 1988 May;38(1):63-70. doi: 10.1002/jso.2930380116.
Islet cell function was studied in pancreatectomized primates with functioning segmental pancreatic allografts more than 100 days after transplantation. Segmental allograft recipients were immunosuppressed with total lymphoid irradiation (TL1) and cyclosporine (CSA). After 100 days, islet function was assessed, at which stage immunosuppression was terminated. Glucose, insulin, glucagon, and C-peptide response was assessed during intravenous glucose tolerance test (IVGTT) and during arginine and tolbutamide stimulation. In eight normoglycaemic primates in which immunosuppressive treatment had been stopped and with mean graft survival of 145 days, islet stimulation was associated with moderate glucose intolerance, reduced K-values, hypoinsulinaemia, and low C-peptide values. Postmortem findings in all animals intentionally killed revealed severe graft atrophy in the absence of significant rejection. Severe graft atrophy in normoglycaemic primates, together with significantly impaired graft function after segmental pancreatic transplantation compared to normal animals, suggest that transplantation of the whole pancreas may be mandatory if normal or near-normal function is to be achieved.
在移植超过100天后，对接受节段性胰腺同种异体移植且有功能的胰腺切除灵长类动物的胰岛细胞功能进行了研究。节段性同种异体移植受者接受了全淋巴照射（TLI）和环孢素（CSA）免疫抑制。100天后，评估胰岛功能，此时终止免疫抑制。在静脉葡萄糖耐量试验（IVGTT）以及精氨酸和甲苯磺丁脲刺激期间，评估葡萄糖、胰岛素、胰高血糖素和C肽反应。在8只血糖正常的灵长类动物中，免疫抑制治疗已停止，平均移植物存活145天，胰岛刺激与中度葡萄糖不耐受、降低的K值、低胰岛素血症和低C肽值相关。所有被故意处死动物的尸检结果显示，在无明显排斥反应的情况下存在严重的移植物萎缩。血糖正常的灵长类动物中严重的移植物萎缩，以及与正常动物相比节段性胰腺移植后移植物功能明显受损，表明如果要实现正常或接近正常的功能，可能必须进行全胰腺移植。
