Microdialysis measurements demonstrate a shift to nonoxidative glucose metabolism in rat pancreatic islets transplanted beneath the renal capsule

Abstract

Background. We aimed to use microdialysis to assess, for the first time, the internal milieu of pancreatic islet grafts. Methods. One month after transplantation, microdialysis probes were inserted into syngeneic rat islet transplants (500-700 islets) placed beneath the renal capsule of nondiabetic or diabetic recipients. The number of grafted islets was purposely chosen not to cure the diabetic recipients. Results. During an intravenous glucose challenge, insulin concentrations increased in parallel in serum and in the graft interstitium of nondiabetic animals suggesting the existence of a functionally well-established vascularization. Diabetic recipients had both a lower serum and dialysate insulin concentration than normoglycemic animals. The lactate/pyruvate ratios were determined in the dialysates as a measure of the degree of anaerobic metabolism in the islet grafts. Lactate/pyruvate ratios were between 50 and 100 in grafts of both nondiabetic and diabetic recipients, and they almost doubled in response to the intravenous glucose challenge in the grafts of nondiabetic recipients. In comparison, lactate/pyruvate ratios were approximately 12 in the medium of cultured islets incubated at low glucose (5.6 mmol/L) or high glucose (16.7 mmol/L) concentrations. Conclusions. The microdialysis technique has proven to be a valuable tool for evaluating the internal environment of islet transplants. Moreover, the high lactate/pyruvate ratio suggests that islet grafts have an increased anaerobic glucose metabolism. (Surgery 2002;132:487-94.)