Experimental Study In Rat Whole Pancreaticoduodenal Kidney Transplantation

One of the most serious complications of type I diabetes Mellitus(IDDM)is the diabetic renal failure. Neither kidney transplant alone nor blood dialysis can essentially solve the problem. A reasonable therapeutic regimen is simultaneous pancreas and kidney transplantation .which will treat diabetes and uremia at the same time and stablize the homeostasis. Clinical data suggest that the survival rate of a functional grafted pancreas in those undergoing simultaneous pancreas and kidney transplantation is higher than those with pancreas transplantation alone, while the functional survival rate of kidney grafts shows no significant differences between kidney transplant alone and combined transplantation of pancreas and kidney. This phenomenon is mostly based on the variations of functional parameters of the graft, with no histopathological evidences to confirm. Thus, controversies remain on whether SPK can fully explain the protection of pancreas by combined grafted kidney. Therefore,it will be of great theoretical value to compare the immunological rejection to the graft in simultaneous pancreas and kidney transplant to that in pancreas or kidney trans(?)lant alone by analyzing both functional and morphological changes of the graft.First,a model of simultaneous pancreas and kidney transplant was established in inbred rats. Such a model was utilized to observe the rejection grading and distribution in allogeneic individuals undergoing simultaneous pancreas and kidney transplantation. Differences of rejection response in simultaneous pancreas and kidney transplant and pancreas or kidney transplant alone were compared according to the functional and morphological indices.Results1. Diabetic models were induced by intravenous STZ injection in inbred lewis rats and en bloc transplantation of pancreas,duo(?)enum and kidney; was successfully performed in 82. 6% of the recipient rats. Function of the grafts and vascular patency were evaluated. Results indicate that the model is practically feasible. The recipient rats can survive without complications for more than three months and the function of graft remains normal.2. Relationship of rejection response between pancreas and kidney harvested from the same donor was studied on simultaneous pancreas and kidney allotransplantation (SD—Wistar). Results showed:interstitial rejection of kidney occured earlier than that of pancreas,and its severity greater than that of pancreas,which was the most obvious at the early stage (X~2 test,P<0. 05). However,vascular rejection responses between the two org(?)ns showed no significant difference (X~2 test,P>0.05))...