Blood flow in the pancreatic segment before and after transplantation

Blood flow in the pancreas before and after transplantation has not been studied sufficiently. Blood flow in the pancreatic transplant as a function of type vascular anastomosis used has not been explored.

The objective of our study was to study blood flow in the intact pancreas prior to harvesting and at different time periods after transplantation. Two different types of vascular anastomosis were used for segmental transplantation of the pancreas. Blood flow in the transplanted pancreas was compared in this two experimental groups.

Study was conducted on 61 mongrel dogs. Autotransplantation of a pancreatic segment was performed to the left iliac vessels. There were two randomized experimental groups. In the first group (26 animals) traditional vascular anastomosis was used to revascularize pancreatic graft. Proximal end of splenic artery was anastomosed to iliac artery in "end to side" manner. Portal end of splenic vein was anastomosed to iliac vein in "end to side" manner as well. Splenic ends of splenic artery and vein were ligated. In the second group (35 animals) double arterial double venous anastomosis was used. For this purpose, after completing traditional vascular anastomosis, second arterial anastomosis was created distal to the first one between distal end of splenic artery and iliac artery in "end to side" fashion. Second venous anastomosis was performed distal to the first one between splenic end of splenic vein and iliac vein in "end to side" fashion. Blood flow in the pancreatic segment was measured using direct blood flow measurement method and electromagnetic flowmetry. After transplantation of pancreatic segment, blood flow was measured in the pancreatic graft 3 min, 1 h, 1 and 6 months following transplantation.

Blood flow in the pancreas before harvesting was 0.69 +/- 0.01 ml/min/g. Blood flow in the pancreatic transplant in traditional vascular anastomosis group was higher than blood flow in the normal pancreas (1.13 +/- 0.05 ml/min/g after one month and 1.00 +/- 0.05 ml/min/g after six months (p < 0.01)). Blood flow in the double arterial double venous anastomosis group was not statistically significantly different from blood flow in the normal pancreas at 1 and 6 months after transplantation (0.70 +/- 0.02 and 0.67 +/- 0.02 ml/min/g accordingly).

Double arterial double venous anastomosis provided more physiological blood flow to the graft, than traditional vascular anastomosis.