KU Yonson Kobe University Hospital, Research Associate, 医学部附属病院, 助手 (40195615)
OHYANAGI Harumasa Kobe University School of Medicine, Associate Professor, 医学部, 助教授 (00030958)
SAITOH Yoichi Kobe University School of Medicine, Professor, 医学部, 教授 (90004803)
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
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