Surgical Tips and Tricks for Performing Porcine Pancreas Transplantation

Ray, Samrat; Parmentier, Catherine; Mazilescu, Laura; Kawamura, Masataka; Noguchi, Yuki; Nogueira, Emmanuel; Ganesh, Sujani; Arulratnam, Bhranavi; Selzner, Markus; Reichman, Trevor

doi:10.3791/64203-v

Cited by 2 publications

(2 citation statements)

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“…The anesthesia and surgery protocol in recipient operation followed the same steps as described by our group previously. 17 Broad-spectrum antibiotics (metronidazole 500 mg and cefazolin 1 gm) and proton pump inhibitor (pantoprazole 20 mg IV) were administered at induction. The surgery comprised of 2 parts: pancreatectomy and graft implantation.…”

Section: Methodsmentioning

confidence: 99%

“…The central venous catheter was secured in the neck by creating a subcutaneous tunnel as described elsewhere by our group. 17 The animal was transferred to the housing facility, extubated, and monitored for the next 72 h (3 d). Postoperatively, the animals received cefazolin 1 g IV twice per day and methylprednisolone 500 mg IV per day till sacrifice, besides the appropriate analgesics and intravenous fluids.…”

Section: Methodsmentioning

confidence: 99%

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Reanimating Pancreatic Grafts Subjected to Prolonged Cold Ischemic Injury Using Normothermic Ex Vivo Perfusion

Ray,

Parmentier,

Kawamura

et al. 2024

Transplantation Direct

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Background. Pancreas transplant volumes are limited because of poor utilization of “extended criteria grafts.” Prolonged cold ischemia is a risk factor associated with poor allograft survival. We aimed to establish the feasibility of transplantation using grafts subjected to prolonged cold ischemia and determine whether these grafts could be optimized using normothermic ex vivo perfusion (NEVP) in a porcine model. Methods. The study population consisted of 35 to 40 kg male Yorkshire pigs in an allotransplantation model with a 3-d survival plan for recipients. Control grafts were subjected to cold storage (CS) in a University of Wisconsin solution for 21 to 24 h (n = 6), whereas the test group received an additional 3 h NEVP after CS of 21 h (n = 5). Results. The 3-d survival was 60% in the NEVP arm versus 0% in the control arm (P = 0.008; log rank). Graft parenchyma was 60% to 70% preserved in the NEVP arm at necropsy on gross appearance. In addition, the islet function was well preserved, and both the pancreas (including the islets) and the duodenal morphology were maintained histologically. The intravenous glucose tolerance test on the day of euthanasia was in the normoglycemic range for 80% of cases in the NEVP arm. Conclusions. Optimization of pancreas grafts exposed to extended CS with NEVP seems promising at rescuing and reanimating these grafts for transplantation, resulting in significantly improved survival in a porcine pancreas transplant model.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%