1993
DOI: 10.1002/bjs.1800800935
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Morphological studies of graft pancreatitis following pancreas transplantation

Abstract: Morphological findings in the initial stages of graft pancreatitis were studied systematically in sequential biopsies of 16 human pancreatic allografts. In 14 patients clinical and morphological signs of graft pancreatitis developed in the early postoperative period. In all cases disturbances in the integrity of structures within acinar cells occurred during ischaemia. In ten cases activation of autophagocytosis occurred following reperfusion, with acceleration of cellular metabolism. After reperfusion a marke… Show more

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Cited by 78 publications
(31 citation statements)
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“…Indeed, analysis of sequential biopsies of human pancreatic allografts confirmed both clinical and morphological signs of acute pancreatitis, making post-transplant pancreatitis a manifestation of ischemia-reperfusion injury [2, 31. Besides the disturbed integrity of structures within the acinar cells, which can clearly be attributed to the ischemic insult, reperfusion-associated events are thought to account for other distinct cellular and metabolic responses, including autophagocytosis, acceleration of cellular metabolism, and leukocyte activation/reaction. These, in turn, may lead to acinar cell necrosis [2,3]. Accordingly, reperfusion of pancreatic transplants after 6 h, but not after 1 h, of cold storage revealed classical pancreatitis-associated microvascular injury, i. e., the deterioration of nutritive blood supply (no-reflow), lending support to the role of ischemia/reperfusion-associated mechanisms in the manifestation of acute post-transplant pancreatitis.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Indeed, analysis of sequential biopsies of human pancreatic allografts confirmed both clinical and morphological signs of acute pancreatitis, making post-transplant pancreatitis a manifestation of ischemia-reperfusion injury [2, 31. Besides the disturbed integrity of structures within the acinar cells, which can clearly be attributed to the ischemic insult, reperfusion-associated events are thought to account for other distinct cellular and metabolic responses, including autophagocytosis, acceleration of cellular metabolism, and leukocyte activation/reaction. These, in turn, may lead to acinar cell necrosis [2,3]. Accordingly, reperfusion of pancreatic transplants after 6 h, but not after 1 h, of cold storage revealed classical pancreatitis-associated microvascular injury, i. e., the deterioration of nutritive blood supply (no-reflow), lending support to the role of ischemia/reperfusion-associated mechanisms in the manifestation of acute post-transplant pancreatitis.…”
Section: Discussionmentioning
confidence: 99%
“…While graft thrombosis occurs in 10 %- [20], depending on the severity of the disease. The clinical picture of post-transplant pancreatitis is ascribed to microvascular damage caused by ischemia and/or preservation of the organ, followed by reperfusion [3]. In contrast to inflammatory complications of the exocrine gland, ischemia/reperfusion-induced dysfunction of the endocrine tissue is rarely observed [31].…”
Section: Introductionmentioning
confidence: 99%
“…5) I/R injury of the pancreas has been observed in several clinical situations, such as shock, 6) cardiac or aortic surgery using cardiopulmonary bypass (CPB), 7) and pancreatic transplantation. 8) However, I/R injury of the pancreas, associated with acute aortic dissection, has not been fully recognized, and its precise incidence is unclear due to its rarity.…”
Section: Discussionmentioning
confidence: 99%
“…The notion that this surge represents a reversal in secretory polarity in the acinar cell [97]is supported by in vivo studies of transplant pancreatitis (fig. 3) [98, 99], while the belief that prolonged pancreastasis favours necrotising disease [11]is strengthened by observations on fragments from patients with acute pancreatitis who required surgical intervention [100]: both investigations demonstrate cytoplasmic vacuolation of acinar cells (fig. 3) with tubular complexes which indicate their redifferentiation and loss of ability to synthesise protein.…”
Section: Back To the Futurementioning
confidence: 99%
“…3 Composite of images on human graft pancreatitis from Büsing et al [99] – reproduced with permission, and incorporating information on functional changes from Keim et al [98]. Ultrastructural study shows cytoplasmic vacuoles of various size within acinar cells (arrowed in top left image), and (top right image) the start of single cell necrosis (arrowed), involvement of capillaries, extravasation of erythrocytes, slight fibrin deposition and infiltration with granulocytes.…”
Section: Back To the Futurementioning
confidence: 99%