Experimental Research for Pancreas Transplantation

1.为了减少胰腺移植的技术问题，我们开发了一种新技术，将胰腺移植物置于颈部，通过胰管食管吻合术进行外分泌引流（Transplantation 44，583，1987）。这一次，我们确保了自体移植物在至少3年内保持正常的外分泌和内分泌功能（参考文献4），并证明了这种方法用于胰腺同种异体移植的安全性（参考文献7）。我们开发了一种新的双层简单冷藏方法，使用全氟化合物（PFC）保存犬胰腺（Transplantation 46，457，1988和参考文献2）。使用Euro-Collins溶液（EC）作为保存液，我们将犬胰腺保存时间延长至72小时（参考文献3和8）。此外，通过该方法使用UW溶液代替EC实现了犬胰腺99小时的保存（参考文献9）。阐明了该方法保存胰腺的氧合机制， 关于我们 d（参考文献6）和胰腺的氧合允许移植物内持续产生ATP，并且可以维持对细胞完整性至关重要的代谢过程，这产生了延长的保存胰腺活力的时间（参考文献13）。我们还发现，移植后的移植物功能与ATP组织浓度相关，双层方法提供的高ATP水平与上级结果相关（参考文献11），该方法冷保存结束时的ATP组织水平将预测移植后胰腺移植物的存活率（参考文献12）。为了将该方法转移到临床环境中，我们已经阐明了人胰腺也是氧合的，并且在至少48小时的保存期间保持高ATP组织浓度（参考文献14）。我们发现，在实验性犬胰腺排斥反应的早期过程中，血清胰腺分泌型胰蛋白酶抑制剂（PSTI）升高（Transplantation 46、493、1988和参考文献1），免疫抑制药物可抑制这种升高（参考文献7）。在临床胰腺移植排斥反应中，血清PSTI也是一种早期敏感和可靠的标志物（参考文献10）。少

1. To minimize technical problems in pancreas transplantation, we developed a new technique in which a pancreas graft was placed in the neck, with exocrine drainage by pancreatic ductesophageal anastomosis in dogs (Transplantation 44, 583, 1987). This time we have made sure that the autograft maintains normal exocrine and endocrine functions during at least 3 years (Ref. 4) and also demonstrated the safety of this method for pancreas allotransplantation (Ref. 7).2. We developed a new two-layer-simple cold storage method using perfluorochemical (PFC) for canine pancreas, preservation (Transplantation 46, 457, 1988, and Ref. 2). Using Euro-Collins' solution (EC) as a preservation solution, we have extended the canine pancreas preservation time up to 72 hours (Ref. 3 and 8). In addition 99 hour preservation of canine pancreas has been achieved by this method using UW solution in place of EC (Ref. 9). We have clarified the mechanism of pancreas oxygenation during preservation of this metho … More d (Ref. 6) and oxygenation of the pancreas allows continued ATP production within the graft and metabolic processes vital to cellular integrity can be maintained, which produces an extended period of preserved pancreatic viability (Ref. 13). We also have found that graft function after transplantation is correlated with ATP tissue concentration, with superior results associated with high ATP level provided by the two layer method (Ref. 11) and the tissue level of ATP at the end of cold preservation by this method will predict the viability of the pancreas graft following transplantation (Ref. 12). To transfer this method to clinical settings, we have clarified that human pancreas is also oxygenated and maintains high ATP tissue concentration during at least 48 hour preservation (Ref. 14).3. We found that serum pancreatic secretory trypsin inhibitor (PSTI) was elevated in the early process of experimental canine pancreas rejection (Transplantation 46, 493, 1988 and Ref. 1) and this elevation is suppressed by immunosuppressive drugs (Ref. 7). In clinical pancreas graft rejection, serum PSTI is also an early sensitive and reliable marker (Ref. 10). Less