PANCREATIC TRANSPLANTATION IN THE RAT LONG-TERM STUDY FOLLOWING DIFFERENT METHODS OF MANAGEMENT OF EXOCRINE DRAINAGE

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Abstract
A major problem in pancreas transplantation is the management of exocrine drainage. Isotransplantation has been performed in streptozotocin-induced diabetic rats using a microsurgical technique, and 4 methods of exocrine drainage have been compared over a 9-mo. period. The duct system was ligated, left open to drain into the peritoneal cavity, or obliterated with latex or with Ethibloc I occlusion gel. Biochemical follow-up included determinations of serum glucose concentration, i.v. and oral glucose tolerance tests (GTT), and insulin assays. Histological studies were performed at 1 and 9 mo. posttransplant. All animals became normoglycemic after the operation. Although 25 out of 28 remained normoglycemic throughout the period of study, oral GTT performed at 6 mo. indicated impaired endocrine function in some of the ligated, freely draining, and Ethibloc I-obliterated animals. Latex-obliterated grafts showed normal oral GTT up to 9 mo. postoperatively. Intravenous GTT showed impairment of endocrine function in all groups, but this was least evident in the latex-obliterated rats. These changes were supported by the peak serum insulin levels during the GTT. Histologically, long-term ligated, freely draining, and Ethibloc I-obliterated pancreas grafts showed similar degrees of exocrine degeneration, fibrosis, and disruption of islets of Langerhans. Longer term latex-obliterated pancreas grafts demonstrated minimal exocrine tissue and intact islets.