Transplantation of the entire pancreas with ligation of the exocrine ducts : an experimental study in dogs

The relevance of pancreas transplantation is discussed in the Introduction to this thesis. Chapter I gives the historical background, the specific problems in relation to previous research, the surgical techniques applied, and a review of the clinical pancreas transplantation performed so far. The conflicting results published by various investigators concern the long-term quality of the endocrine function of the organ when the exocrine function is abolished by ligation of the pancreatic ducts. As a result, in extensive series of experimental pancreas transplantations and a number performed in patients the endocrine function was maintained intact, which can only be achieved by including the duodenum, applying the Roux technique for anatomosis with the pancreas, or establishing an anastomosis between the pancreatic duct and the ureter. The disadvantages of these methods are discussed and the advantages of transplanting the pancreas with ligated ducts are indicated. The latter method requires only a vascular anastomosis and is in fact even less complicated than a kidney transplantation. On the basis of these considerations we thought it worthwhile to investigate the effects of transplantation of the pancreas with ligated ducts. This study was performed in dogs, and the effect of tissue typing for SO determinants of the DL-A complex on allograft survival was included in the investigation.

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