The present study suggests that the ischemic tolerance of human pancreata cannot be extended by TLM preservation. In addition, TLM does not seem to improve the isolation outcome for pancreata from elderly donors.

Vasoactive intestinal polypeptide (VIP) is a highly potent vasodilatator. Cardiovascular changes and plasma VIP levels were studied during endotoxinaemia (Escherichia coli endotoxin 1 mg/kg) in a carefully monitored porcine model. Endotoxin infusion resulted in a profound but reversible shock and a substantial rise in plasma VIP levels. Increased levels of VIP could be demonstrated already after 30 min of endotoxin infusion and increased further during the infusion. Animals followed for a period of 60 h demonstrated slowly declining levels of VIP after endotoxin infusion but significantly elevated levels were usually found 24 h after infusion. Control animals did not show any changes in VIP during a similar procedure. Release of gastrointestinal peptides may be of importance during septic shock.

In previous studies increased plasma levels of vasoactive intestinal polypeptide (VIP), somatostatin and pancreatic polypeptide (PP) were demonstrated in a porcine endotoxin shock model. Unchanged levels of gastric inhibitory polypeptide (GIP) and secretin point to a specific shock reaction of peptide release and not to a diffuse mucosal leakage. A porcine model of cardiodepressive shock was developed to enable discrimination to be made between a general low-flow state and endotoxin reaction. Infusion of the tricyclic antidepressive agent nortriptyline 15 mg/kg bodyweight resulted in a grave shock state. Increased plasma levels of somatostatin, PP and insulin were found. No increase in VIP levels could be demonstrated. Endotoxin given after nortriptyline administration resulted in the increase of VIP levels regularly seen during endotoxinaemia. VIP release during endotoxin shock is related to endotoxin and not to a general low flow state.

Hemorrhagic shock caused by gastrointestinal bleeding in seven pigs and by external bleeding in another six pigs and cardiogenic shock induced by intravenous infusion of the tricyclic antidepressant drug nortriptyline in yet another eight pigs caused a significant increase in serum cationic trypsin-like immunoreactivity together with formation of complexes between cationic trypsin, on the one hand, and alpha-2-macroglobulin and alpha-1-antitrypsin, on the other hand, compatible with what happens in acute pancreatitis.