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

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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.