Segmental porcine pancreatic autotransplantation as model for pancreas preservation studies using two different techniques for vascular reconstruction.

摘要

Pancreatic segmental autotransplantation in the pig has been considered an attractive model to study several aspects of pancreas transplantation because of the absence of rejections related to the immune system. However, the frequent presence of anatomical variations in the vascular supply of the left pancreatic segment in the pig makes this model difficult, impairing the access for vascular flushing and revascularization in pancreatic autotransplantation. We assessed pancreatic vascular anatomy of 71 Landrace pigs: group I (G1, n = 32) transplanted after direct reconstruction of the hepatic flow; and group II (G2, n = 39) transplanted after hepatic-celiac arterial reconstruction (HECAR) with an iliac vascular graft between the celiac trunk and the hepatic artery. HTK (histidine-tryptophan-ketoglutarate; Custodiol) and UW (University of Wisconsin; Viaspan) solutions were used. In total, 23 technically successfully transplanted animals (HTK = 15; UW = 8) after 24 h of cold storage were studied. Reconstruction time was longer in G2 than in G1 (p = .04). Thrombosis of the reconstructed hepatic artery occurred more in G1 than in G2 (45% vs. 8%, respectively, p = .013). Pancreatic arterial thrombosis was noticed in 10 animals in G1 (32%) and in 2 in G2 (5%) (p = .026). Ninety-four percent of pancreas grafts were suitable for cold storage study in G2 versus 45% for G1 (p < .001). No differences were noticed in K values, weight of transplanted grafts, preoperative and 24 h postoperative glycemia, for both preservation solutions. Segmental pancreatic autotransplantation can be successfully performed for cold preservation studies. A high percentage of pancreas useable for transplantation can be achieved using hepato-celiac arterial reconstruction. HTK solution is suitable for flushing and 24 h of preservation for pancreatic grafts in the porcine model.