Review of Various Techniques of Pancreas Transplantation in Rat Model

Abstract

Pancreas transplantation (PTx) is being applied with increasing frequency in the treatment of diabetes mellitus Type 1 and selected cases of Type 2. It is known that PTx can consistently establish normoglycemic insulin-independent state. Due to the increased use of different PTx models in rats for studying the metabolic function of the transplanted pancreas, reviewing the various techniques in PTx seemed to be necessary. A review of the literature of PTx in rat models showed that different techniques or modifications have been described. Each modification is the result of a change or simplification of three main points: the arterial inflow, the venous outflow, and the management of the exocrine secretory part of the gland. The techniques of PTx vascularization in rats are based on two cardinal models, which include the microsuture and non-suture cuff techniques. In arterial inflow reconstruction, an aortic segment is used. Venous drainage is accomplished by systemic or portal drainage (porto-caval or porto-portal anastomosis). Management of the exocrine part has the most variations. Enteric and urinary diversion, as well as duct ligation or obstruction, are the most important techniques for the management of exocrine part. Regarding vascular anastomosis, the microsuture technique is more popular than the cuff technique. However the cuff technique seems to be simpler. Grafts with portal venous drainage show a lesser probability of hyperinsulinemia and a high level of lipoproteins. In the management of the exocrine part, enteric exocrine drainage is more similar to the physiological setting and is associated with a significant reduction in the incidence of acidosis and dehydration. However, enteric diversion is more prone to intestinal bleeding and ileus as well as to bacterial contamination. The technique for PTx in rat varies according to surgeons' experiences and preferences as well as their research objectives.