Pancreatic autotransplantation

Segmental pancreatic autotransplantation is successful in our hands if blood flow through the splenic artery is enhanced by either a jump graft or a distal fistula, and if these technical manoeuvres are supplemented by anticoagulation. We found the jump method of arterial anastomosis was the most successful. Perfusion of the isolated graft is not necessary, and may even be harmful. Ischemia up to 3 hours appears to be well tolerated. The intraperitoneal location of the graft does not affect outcome, but preservation of the left gastric artery reduces mortality secondary to stomach and omentum ischaemia. Animals must be supplemented with Viokase 10 tablets daily. If the remaining pancreas has been removed graft function is best assessed by monitoring blood sugars. No animal recovers which becomes diabetic under these conditions. Serum insulin, serum glucagon and glucose tolerance tests (with or without calculation of K values) are no more useful than blood glucose to recognize graft loss.