BACKGROUND: Although various suture techniques for murine
pancreas transplantation have been described, severe limitations have limited their widespread use. We therefore designed a
surgical model for cervical heterotopic
pancreas transplantation using a cuff technique. METHODS: C57BL6
mice were used as donor and recipient pairs. Recipients were rendered
diabetic with
streptozotocin and subsequently transplanted. The donor pancreas was isolated using a no-touch technique and then placed in the recipient's cervical region. Vascular
anastomoses were completed by pulling the portal
vein over the
external jugular vein cuff and the donor
aortic segment over the
carotid cuff and fixed with an 8-0 ligature thereby facilitating a nonsuture technique. To test applicability of this model,
graft microcirculation was evaluated by intravital
microscopy after prolonged
cold ischemia (16 h). RESULTS: The immediate success rate was >90%. Donor operation lasted 40 +/- 5 min;
dissection of recipient vessels lasted 20 +/- 4 min.
Revascularization time was 4 to 6 min, resulting in a total pancreas
ischemia time of 33 +/- 6 min. No thromboembolic complications on the cuff side were observed. Preoperative
glucose levels were 518 +/- 59 mg/dl and returned to normal by postoperative day 1 (88 +/- 13 mg/dl).
Histology on postoperative days 10 and 30 showed almost normal
islet cell and
acinar architecture of all
grafts. In groups with prolonged
cold ischemia,
graft microcirculation was significantly reduced and paralleled by increased
inflammation, interstitial edema,
hemorrhage,
acinar vacuolization, and focal areas of
necrosis compared with nonischemic controls. CONCLUSIONS: This new model may provide an excellent tool to further investigate the
pathophysiology as well as novel therapeutic strategies of preservation,
ischemia reperfusion injury, and
graft pancreatitis.
