Shokouh-Amiri M H, Rahimi-Saber S, Andersen H O, Jensen S L
Department of Surgical Gastroentology C, Rigshospitalet, University of Copenhagen, Denmark.
Transplantation. 1996 Apr 15;61(7):1004-9. doi: 10.1097/00007890-199604150-00003.
The effect of the type of venous drainage of the graft on its endocrine function was studied in two groups of pigs after segmental pancrease autotransplantation. Group 1 comprised 10 pigs with portal venous drainage (PVD) and group 2 comprised 10 pigs with systemic venous drainage (SVD). The graft consisted of body and tail of the pancreas. The pigs were totally pancreatectomized. The pancreatic duct was occluded by neoprene injected into the duct. One week before and 1 and 3 months after transplantation, intravenous glucose tolerance (IVGTT) and meal stimulation tests (MST) were performed. Plasma glucose (PG), insulin (INS), C-peptide, glucagon (GLU),and pancreatic polypeptide (PP) were measured during the tests. All pigs had normal fasting PG, 1 and 3 months after PanTx, although MST disclosed significantly higher PG (P<0.05) during the test after transplantation. In the PVD group, a decrease in INS level during both test was recorded after PanTx (P<0.05), while in the SVD group a nonsignificant rise in INS level was recorded compared with before transplant. A significant difference (P<0.05) in INS levels were present both 1 and 3 mon. after PanTx between the two groups. Pigs with PVD showed a higher (P<0.05) C-peptide level than pigs with SVD during IVGTT. The initial significant rise in PP during MST and the initial fall in PP during IVGTT recorded in all pigs before transplantation were totally lost after transplantation in both groups. During the tests, PP remained steady and significantly lower than the pretransplantation levels in both groups. A significantly higher GLU level during both IVGTT and MST was observed in SVD compared with PVD 1 month after PanTx (P<0.05), being more pronounced during MST. This accentuated GLU concentration decreased by 3 months after transplantation, although it was still significantly greater than pretransplantation levels. We concluded that the unnatural mode of delivery of pancreas endocrine secretion to systemic rather than to portal circulation leads to derangements in pancreatic endocrine function in order to maintain glucose homeostasis. This may cause earlier exhaustion of islet cells. Segmental rather than whole organ and duct occlusion rather than exocrine drainage may further contribute to this, shortening the effective life of the graft.
在两组猪进行节段性胰腺自体移植后，研究了移植胰腺静脉引流类型对其内分泌功能的影响。第1组包括10头门静脉引流（PVD）的猪，第2组包括10头体静脉引流（SVD）的猪。移植胰腺由胰体和胰尾组成。这些猪均接受了全胰切除术。通过向胰管内注入氯丁橡胶来阻塞胰管。在移植前1周以及移植后1个月和3个月，进行静脉葡萄糖耐量试验（IVGTT）和进餐刺激试验（MST）。在试验过程中测量血浆葡萄糖（PG）、胰岛素（INS）、C肽、胰高血糖素（GLU）和胰多肽（PP）。所有猪在胰腺移植后1个月和3个月时空腹PG均正常，尽管MST显示移植后试验期间PG显著升高（P<0.05）。在PVD组中，胰腺移植后两次试验期间INS水平均下降（P<0.05），而在SVD组中，与移植前相比，INS水平有不显著的升高。胰腺移植后1个月和3个月时，两组之间INS水平存在显著差异（P<0.05）。在IVGTT期间，PVD组猪的C肽水平高于SVD组猪（P<0.05）。在移植前所有猪在MST期间PP最初的显著升高以及在IVGTT期间PP最初的下降在两组移植后均完全消失。在试验过程中，两组PP均保持稳定且显著低于移植前水平。胰腺移植后1个月，与PVD组相比，SVD组在IVGTT和MST期间GLU水平均显著更高（P<0.05），在MST期间更为明显。这种GLU浓度的升高在移植后3个月时下降，尽管仍显著高于移植前水平。我们得出结论，胰腺内分泌分泌物输送到体循环而非门静脉循环这种不自然的方式会导致胰腺内分泌功能紊乱，以维持葡萄糖稳态。这可能导致胰岛细胞更早耗尽。节段性而非整个器官以及胰管阻塞而非外分泌引流可能会进一步加剧这种情况，缩短移植胰腺的有效寿命。
