“…As shown by Benz et al transplantation-related microcirculatory deteriorations, as reflected by decreased graft tissue pO 2 and hemoglobin oxygen saturation in the venous effluent of human pancreatic grafts, lasted as long as 1 h during the post-transplantation reperfusion phase (15). Among other mechanisms, microcirculatory impairment reflected by capillary perfusion failure with profound endothelial dysfunction increased microvascular permeability (10,27,31,32), and enhanced leukocyteendothelial cell interaction have been characterized under experimental conditions and are expected to trigger subsequent reperfusion-mediated manifestation of graft pancreatitis. These post-transplant alterations were also observed in the present clinical study, demonstrating increased intercapillary distance, reduced FCD and red blood cell velocity as well as scattered microvascular thrombosis, all indicative of capillary 'no-reflow' during the initial 30-min graft reperfusion period.…”