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Total Pancreatectomy and Pancreatic Allotransplant in a Porcine Experimental Model
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Edité par CCSD -
International audience. Objectives: The main objective of this experimental study was to evaluate the feasibility of diabetes induction by total pancreatectomy and pancreatic allotransplant after diabetes induction by total pancreatectomy. The secondary objective was to evaluate metabolic (C-peptide, glycemia) and inflammatory (lactate and platelet levels) parameters after diabetes induction by total pancreatectomy and pancreatic allotransplant after total pancreatectomy. Materials and Methods: The study protocol wasapproved by the French Minister of Research (APAFiS no.18169). Insulin-dependent diabetes was induced bytotal pancreatectomy in one male Susscrofa pig, and pancreatic allotransplant was performed, after total pancreatectomy, in 3 male Susscrofa pigs. Total pancreatectomy was performed under general anesthesia, with meticulous dissection of the portal veinand the splenic vein to preserve the spleen. Concerning pancreas procurement, extensive pancreas preparation occurred during the warm phase, before cold perfusion. Pancreatic allotransplant was performed using donor aorta (with superior mesenteric artery and celiactrunk).Results: Diabetes induction was successful, with negative C-peptide values at 3 hours after total pancreatectomy. Glycemic control without hypoglycemic events was obtained with the use of long-acting insulin administered once per day. No rapid-acting insulin was used. In animals that received pancreatic allotransplant, after enteral feeding was started, glycemic control without hypoglycemic events and without insulin was obtained in 2 animals.Conclusions: In an experimental porcine model, diabetes induction by total pancreatectomy and pancreatic allotransplant after total pancreatectomy are feasible and effective. The development of these models offers the potential for new investigations into ischemia-reperfusion injuries, improvement of pancreas procurement methods, and preservation techniques.
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