Hesse U J, Meyer G P, Weyer J, Danis J, Pichlmaier H
Department of Surgery, University of Cologne.
Zentralbl Chir. 1994;119(9):653-60.
Despite recent considerable progress in the isolation and purification of porcine pancreatic islets the final proof of functional integrity has not yet been performed. In the present study the feasibility, technical problems and posttransplant metabolic function of islet transplantation in the pig were investigated. Intraductal collagenase perfusion technique for islet preparation was used in 27 landrace pigs and eight minipigs followed by intraportal or intrasplenic transplantation of the islets. Islet purification was performed by dextran gradient in six preparations. Islet quantification, portal vein pressure measurements, intra- and postoperative complications and postoperative graft function were monitored. Between 1.73 x 10(5) and 11.4 x 10(5) islet containing fragments (8.23 x 10(3)-54.28 x 10(3) islet containing fragments/kg recipient body weight) were transplanted. Portal vein thrombosis occurred in 4 animals with significantly elevated portal pressure (p = 0.0001). 11 of 27 landrace pigs died due to postoperative complications. None of the minipigs was lost due to perioperative mortality (p = 0.031). Four of eight landrace pigs with intrasplenic grafts (50%) were normoglycemic and two of eight landrace pigs with intrahepatic transplants (25%) were normoglycemic. In minipigs two out of four (50%) with intrasplenic transplants and two of four (50%) with intraportal transplants were normoglycemic. The results in glucose metabolism as measured with intravenous glucose tolerance tests and calculated by K-values were statistically significantly different between normoglycemic and hyperglycemic animals (landrace pigs p = 0.0002 and minipigs p = 0.0005). Longevity was prolonged in normoglycemic animals as compared to hyperglycemic and apancreatic animals. It is concluded that successful islet isolation and transplantation is feasible in the landrace pig and the minipig while the landrace pig appears to be more susceptable to perioperative mortality.
尽管近期在猪胰岛的分离和纯化方面取得了显著进展，但尚未对其功能完整性进行最终验证。在本研究中，对猪胰岛移植的可行性、技术问题及移植后的代谢功能进行了研究。采用导管内胶原酶灌注技术制备胰岛，共对27头长白猪和8头小型猪进行了操作，随后将胰岛进行门静脉或脾内移植。6份样本通过葡聚糖梯度法进行胰岛纯化。监测胰岛定量、门静脉压力测量、术中和术后并发症以及术后移植物功能。共移植了1.73×10⁵至11.4×10⁵个含胰岛片段（8.23×10³至54.28×10³个含胰岛片段/千克受体体重）。4只动物发生门静脉血栓形成，门静脉压力显著升高（p = 0.0001）。27头长白猪中有11头因术后并发症死亡。小型猪无一例因围手术期死亡而丢失（p = 0.031）。8头接受脾内移植的长白猪中有4头（50%）血糖正常，8头接受肝内移植的长白猪中有2头（25%）血糖正常。在小型猪中，4头接受脾内移植的有2头（50%）血糖正常，4头接受门静脉移植的有2头（50%）血糖正常。通过静脉葡萄糖耐量试验测量并用K值计算的葡萄糖代谢结果在血糖正常和高血糖动物之间存在统计学显著差异（长白猪p = 0.0002，小型猪p = 0.0005）。与高血糖和胰腺切除动物相比，血糖正常动物的寿命延长。结论是，在长白猪和小型猪中成功进行胰岛分离和移植是可行的，而长白猪似乎对围手术期死亡更敏感。
