Objective: To study the markers of early rejection and pathological changes in simultaneous pancreati- coduodenal and kidney transplantation (SPKT). Methods: Thirty hybrid pigs were used as donors and recipients. A re...Objective: To study the markers of early rejection and pathological changes in simultaneous pancreati- coduodenal and kidney transplantation (SPKT). Methods: Thirty hybrid pigs were used as donors and recipients. A renoportal end-to-end anastomosis be- tween the left renal vein and the distal end of the portal vein was performed. Two vascular end-to-side anastomoses between the donor portal vein and recip- ient inferior vena cava, and between the donor aortic segment including the celiac and superior mesenteric, and left renal arteries and recipient abdominal aorta were carried out. Pancreas exocrine secretion drain- age was established with duodenocystostomy. Ureter- ostomosis of the graft was performed. Urine amylase level, fasting blood glucose and urine volumes of kid- ney allograft were monitored, and pathological chan- ges of graft were observed. Results: Of 15 recipients, 2 died of disturbance of in- ternal environment and anastomotic bleeding, re- spectively. Satisfactory results were obtained in the remaining 13 recipients. The changes of urine amyl- ase concentration were prior to those of fasting blood glucose and urine volumes of kidney allograft. The degree of rejection of the kidney allograft was more severe than that of the pancreas and duodenum al- lograft. Conclusions: Urine amylase is the early marker of a- cute rejection in SPKT with bladder drainage of pan- creatic exocrine secretion. The pathological change of kidney allograft is most significant in SPKT.展开更多
基金This project was supported by a grant from the Science Commission of Jiangsu Prorince (No.BS99061).
文摘Objective: To study the markers of early rejection and pathological changes in simultaneous pancreati- coduodenal and kidney transplantation (SPKT). Methods: Thirty hybrid pigs were used as donors and recipients. A renoportal end-to-end anastomosis be- tween the left renal vein and the distal end of the portal vein was performed. Two vascular end-to-side anastomoses between the donor portal vein and recip- ient inferior vena cava, and between the donor aortic segment including the celiac and superior mesenteric, and left renal arteries and recipient abdominal aorta were carried out. Pancreas exocrine secretion drain- age was established with duodenocystostomy. Ureter- ostomosis of the graft was performed. Urine amylase level, fasting blood glucose and urine volumes of kid- ney allograft were monitored, and pathological chan- ges of graft were observed. Results: Of 15 recipients, 2 died of disturbance of in- ternal environment and anastomotic bleeding, re- spectively. Satisfactory results were obtained in the remaining 13 recipients. The changes of urine amyl- ase concentration were prior to those of fasting blood glucose and urine volumes of kidney allograft. The degree of rejection of the kidney allograft was more severe than that of the pancreas and duodenum al- lograft. Conclusions: Urine amylase is the early marker of a- cute rejection in SPKT with bladder drainage of pan- creatic exocrine secretion. The pathological change of kidney allograft is most significant in SPKT.
