Porcine pancreatic transplants II. Allotransplantation of duct ligated segments

Segmental duct ligated pancreatic allografts were performed in pigs. Control untreated grafts underwent significant destruction secondary to inflammation and rejection within 2 weeks following transplantation. Treatment with Solu-Medrol prevented these changes and preserved both the endocrine and the exocrine functions of the allografts. Because of continuing exocrine function, however, large quantities of amylase-rich peripancreatic fluid accumulated and became secondarily infected. Addition of glucagon to this regimen significantly inhibited exocrine pancreatic function and thus prevented fluid accumulation and peripancreatic abscess formation. The additional effect of azathioprine on these grafts was minimal. In conclusion, Solu-Medrol prevents the inflammation, fibrosis, and rejection of duct ligated pancreatic allografts but allows large quantities of amylase-rich peripancreatic fluid to accumulate and become infected. This can be prevented by glucagon, which inhibits the exocrine pancreatic function.