A Simplified Technique of Pancreas Transplantation in a Porcine Model

Abstract

Background: The incidence of diabetes has been steadily increasing. The only curative option for diabetes is pancreas transplantation (PTx). Porcine models are valuable because of their anatomical and physiological similarities to human beings. Our aim is to introduce a simplified technique of PTx in a porcine model. Methods: In Landrace pigs (n = 32), after median laparotomy, the pancreas was mobilized, and the portal and splenic veins were divided. The proper hepatic and splenic arteries and the bile duct were also prepared, and the duodenal bulb was prepared and stapled. The third portion of the duodenum was freed up to the ligament of Treitz and stapled, and the renal arteries were ligated. After systemic heparinization, the pancreas was perfused through the abdominal aorta with histidine-tryptophan-ketoglutarate solution. The portal and splenic veins were cut for evaluating the sufficiency of perfusion. Whole pancreaticoduodenal graft was procured along with an aortic jump graft containing mesenteric and celiac trunks. In recipients, after total pancreatectomy, the suprarenal inferior vena cavaand infrarenal aorta were prepared for vascular anastomosis in an end-to-side manner. After pancreas reperfusion, duodenoduodenostomy was performed in an end-to-side manner. Results: Median cold and warm ischemia times were 10 h (range, 9-14 h) and 50 min (range, 35-80 min), respectively. The hemodynamic status was stable throughout the operation. The median follow-up period was 7 days (range, 4-10). There were no major intra- and postoperative complications. Conclusion: By using an aortic jump graft, there was no need to perform additional arterial reconstruction resulting in a short warm ischemic and operation time. End-to-side portocaval and duodenoduodenal anastomoses make this model of PTx a very feasible method for experimental evaluations.

Comparative aspects of rodent and nonrodent animal models for mechanistic and translational diabetes research

“…The requirement to remove the entire pancreas and not only the endocrine compartment does not reflect the situation in type 1 and type 2 diabetic patients. Therefore, pancreatectomy in pigs is mainly used to develop surgical techniques for pancreatic cancer patients [190] or to prepare insulin-deficient recipients for islet transplantation studies (reviewed in [35]). The effect on glucose control is dependent on the extent of pancreatectomy.…”

Large Animal Models in Regenerative Medicine and Tissue Engineering: To Do or Not to Do

“…Starting in the 1990s, it became so prominent in academic and surgical training that it can be regarded as default model for non-survival surgical teaching classes, substituting the dog (Swindle, 2007). Its ubiquitous presence and use in academia, enabled also its widespread adoption in multiple models of liver, lung, heart, pancreas and kidney transplantation (Marubayashi et al, 1995;Martin et al, 1999;He et al, 2013;Fonouni et al, 2015;Mariscal et al, 2018). Furthermore, in transplantation medicine, the pig has also been proposed as xenograft donor, where porcine grafts have been transplanted into non-human primates with different degrees of success (Sachs et al, 2009;Griesemer et al, 2014).…”

Патоморфоз Печени При Острой Постгеморрагической Ишемии

“…Этот лабораторный вид на сегодняшний день является наиболее часто используемой животной моделью при экспериментальной трансплантации печени и кишечника [1,3,4]. Экспериментальные трансплантации печени изучались у многих млекопитающих, особенно у собак [5], свиней [6,7] и других млекопитающих [8]. Печень крысы является объектом обширных исследований, поскольку недавние данные демонстрируют ее участие в различных процессах (например, секреции, пролиферации, абсорбции и неоангиогенезе), важных для ее патофизиологии [9].…”