Munda R, Berlatzky Y, Jonung M, Murphy R F, Brackett K, Joffe S N, Alexander J W
Arch Surg. 1983 Nov;118(11):1310-5. doi: 10.1001/archsurg.1983.01390110058013.
Success with segmental pancreas transplants has been impaired by immunologic and technical considerations. Experiments were performed with autotransplants to avoid immunologic problems, allowing concentration on surgical techniques. Survival of splenic lobe pancreas autotransplants in pancreatectomized dogs was extended with relocation of the graft from the groin to the abdominal cavity and distal arteriovenous fistula to increase graft flow. Fibrosis of the graft occurred regardless of the method of duct treatment, latex (Neoprene) or Silastic injection or free intraperitoneal drainage. Hormonal responses in normoglycemic animals showed normal insulin levels (6 +/- 0.8 microU/mL) as compared with controls (5.4 +/- 0.9 microU/mL), while peak levels during arginine stimulation were higher in dogs with autotransplants (39.7 +/- 20 microU/mL) than in controls (15.1 +/- 1.9 microU/mL. Pancreatic polypeptide basal levels in animals with transplants were 42 +/- 2.2 pg/mL as compared with 256 +/- 28 pg/mL in controls, with no response to bombesin or protein meal stimulation. In this model, splenic lobe was capable of maintaining normoglycemia with avoidance of ketogenic amino acid patterns. Continuous fibrosis was the biggest threat to islet survival.
节段性胰腺移植的成功受到免疫和技术因素的影响。为避免免疫问题，进行了自体移植实验，以便专注于手术技术。通过将移植物从腹股沟重新安置到腹腔，并建立远端动静脉瘘以增加移植物血流量，可延长胰腺切除术后犬脾叶胰腺自体移植的存活时间。无论采用何种导管处理方法，如乳胶（氯丁橡胶）或硅橡胶注射或腹腔内自由引流，移植物都会发生纤维化。血糖正常的动物的激素反应显示胰岛素水平正常（6±0.8微单位/毫升），与对照组（5.4±0.9微单位/毫升）相比，而自体移植犬在精氨酸刺激期间的峰值水平高于对照组（39.7±20微单位/毫升），对照组为（15.1±1.9微单位/毫升）。移植动物的胰多肽基础水平为42±2.2皮克/毫升，而对照组为256±28皮克/毫升，对蛙皮素或蛋白质餐刺激无反应。在该模型中，脾叶能够维持血糖正常，避免生酮氨基酸模式。持续的纤维化是胰岛存活的最大威胁。
