Cameron J L, Mehigan D G, Harrington D P, Zuidema G D
Surgery. 1980 Apr;87(4):397-400.
A patient with chronic pancreatitis underwent 95% pancreatectomy and islet autotransplantation. The pancreatic tissue was prepared by mincing and collagenase digestion, and then embolized into the liver via the portal vein. The patient has been followed with metabolic studies for 1 year. Fasting normoglycemia returned 3 weeks following operation. Intravenous glucose tolerance tests revealed K values that were similar before operation (1.06), and 3 weeks (0.96) and 4 months (1.09) after operation. Four months after islet transplantation, peripheral, portal, and hepatic vein insulin levels were determined simultaneously following an infusion of glucose (0.25 gm/kg) into the portal vein. During a 10-minute interval, right hepatic vein insulin increased fourfold, left hepatic vein insulin increased twofold, and peripheral vein insulin doubled. During this time portal vein insulin remained constant. In addition, significant levels of pancreatic glucagon were present in both hepatic veins, but were undetectable in the portal vein. At 6 months the patient became hyperglycemic and subsequently has required insulin therapy. Restudy at 10 months following islet transplantation revealed a marked drop in K value (0.34), and no evidence of graft function in the liver. These studies represent convincing evidence of transplanted intrahepatic islet cell function for a 6-month period following operation. The grafts for unknown reasons ceased to function at 6 months.
一名慢性胰腺炎患者接受了95%的胰腺切除术和胰岛自体移植。胰腺组织经切碎和胶原酶消化处理后，通过门静脉栓塞到肝脏。对该患者进行了为期1年的代谢研究随访。术后3周恢复空腹血糖正常。静脉葡萄糖耐量试验显示，术前（1.06）、术后3周（0.96）和4个月（1.09）的K值相似。胰岛移植4个月后，在经门静脉输注葡萄糖（0.25 gm/kg）后，同时测定外周、门静脉和肝静脉的胰岛素水平。在10分钟内，右肝静脉胰岛素增加了四倍，左肝静脉胰岛素增加了两倍，外周静脉胰岛素增加了一倍。在此期间，门静脉胰岛素保持恒定。此外，两条肝静脉中均存在显著水平的胰高血糖素，但门静脉中未检测到。6个月时患者出现高血糖，随后需要胰岛素治疗。胰岛移植后10个月复查显示K值显著下降（0.34），且肝脏中无移植功能的证据。这些研究提供了令人信服的证据，证明术后6个月内移植的肝内胰岛细胞具有功能。移植的胰岛不知何故在6个月时停止了功能。
