The clinical application of split pancreas transplantation for the shortage of donors declared brain dead.

劈离式胰腺移植的临床应用为供者短缺宣告脑死亡。

• 批准号: 10671122
• 负责人: SUGITANI Atsushi
• 金额: $ 2.05万
• 依托单位: KYUSHU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10671122/
• 关键词: Pancreas transplantation; Ischemia-reperfusion injury; Cytokine; Donor; 膵体尾部

1. Although simultaneous pancreas and kidney transplantation has been widely accepted as a treatment of type I diabetes mellitus and diabetic nephropathy, the shortage of donors declared brain dead is a serious problem. The clinical application of split pancreas transplantation could be a possible solution.2. Adult mongrel dogs were used in this study. After dissecting the pancreatic tail, we removed the pancreatic head. We clamped the splenic vessels for 90 minutes. FR167653 (FR) is a low molecular weight inflammatory cytokine inhibitor that inhibits the production of IL-1β and TNFα_ We evaluated the effect of FR for pancreatic ischemia-reperfusion injury by physiological (tissue blood flow), biochemical (exocrine and endocrine function) and morphological parameters (hematoxylin and eosin staining, immunohistochemistry). We also evaluated the secondary damage to the distant organs in pancreatic tail ischemia-reperfusion injury. IL-1β mRNA expression was sigmificantly lower in the FR treatment group than in the control group. Serum lipase and amylase were significantly lower in the FR treatment group than in the control group. Glucose tolelance tests were less damaged in the FR treatment group than in the control group. _In conclusion FR ameliorates the pancreatic ischemia-reperfusion injury, and secondary damage to the distant organs by inhibition of proinflammatory cytokine production.3. We also evaluated the effect of FR for simultaneous pancreatic and renal ischemia-reperfusion injury in dogs After dissecting the pancreatic tail, we removed the pancreatic head and right kidney. We clamped the splenic vessels and left renal vessels for 60 minutes at the same time . FR ameliorates not only the pancreatic ischemia-reperfusion injury but renal ischemia-reperfusion injury.4. We need further consideration to establish the operative procedure of segmented pancreatic preservation and transplantation.

1.虽然胰肾联合移植已被广泛接受作为I型糖尿病和糖尿病肾病的治疗方法，但宣布脑死亡的供体短缺是一个严重的问题。结论：1.劈离式胰腺移植的临床应用是一种可能的解决方案.本研究使用成年杂种犬。在切开胰尾后，我们切除了胰头。我们夹住脾血管90分钟。FR 167653（FR）是一种抑制IL-1β和TNFα产生的低分子量炎性细胞因子抑制剂。我们通过生理学（组织血流量）、生化学（外分泌和内分泌功能）和形态学（苏木精-伊红染色、免疫组织化学）指标评价FR对胰腺缺血再灌注损伤的影响。我们还评估了胰尾缺血再灌注损伤对远端器官的继发性损害。FR治疗组IL-1β mRNA表达明显低于对照组。FR治疗组的血清脂肪酶和淀粉酶显著低于对照组。FR治疗组的葡萄糖耐量试验受损程度低于对照组。结论：FR通过抑制促炎细胞因子的产生，减轻胰腺缺血再灌注损伤，减轻远端器官的继发性损害.我们还评估了FR对犬胰肾同时缺血再灌注损伤的影响。解剖胰尾后，我们切除胰头和右肾。我们同时夹闭脾血管和左肾血管60分钟。FR不仅能减轻胰腺缺血再灌注损伤，还能减轻肾缺血再灌注损伤.节段性胰腺保存和移植的手术方法有待进一步研究。