Physiologic studies of urinary drained pancreaticoduodenal grafts in humans

Exocrine function of urinary drained pancreas transplants (UDP) as determined by measurements of urinary pancreatic metabolites was assessed in 15 recipients. Normal UDP showed significantly higher levels (P less than 0.05) of urinary amylase, (42,931 +/- 5135 U/liter), HCO3 (27.12 +/- 3.18 meq/liter), and pH 7.83 +/- 0.15) than nine other recipients of enteric drained pancreas transplants with corresponding values of 168.00 +/- 2.00 U/liter, 3.20 +/- 0.20 meq/liter, and 6.08 +/- 0.27. These urinary metabolites dropped significantly (P less than 0.02) during rejection to 13,576 +/- 3446 U/liter, 19.22 +/- 5.74 meq/liter, and 7.06 +/- 0.14, respectively. These changes preceded elevation of blood sugar levels by 2-3 days. During rejection episodes, pancreatic grafts failed also to excrete bicarbonate and amylase significantly in response to secretion stimulation (P less than 0.05) contrary to nonrejecting pancreata. It is concluded that decreases in urinary amylase, HCO3, and pH observed with and without secretin stimulation are simple markers of pancreatic rejection.