The early diagnosis of acute pancreas allograft rejection

Abstract

Objectives To investigate the implication of TNF-α level and amylase in pancreatic juice and recipient blood glucose level in the early diagnosis of acute pancreatic allograft rejection.Methods The total pancreatoduodenal transplantation were successfully performed in total pancreatectomy pigs.In group one no immunosuppression was used;in group 2,the animals were treated with Trimperygium Wilforrdii (TW)and methylprednisolsone(MP);in group 3,the animals were treated with cyclosporine A(CsA),TW and MP.The levels of amylase and TNF-α in pancreatic juice and glucose level in blood were determined.Results The pancreatic juice amylase level in the untreated animals was continuously decreased after the 4th posttransplant day.After the eighth day the pancreatic juiee output of most grafts stopped.In group 2,pancreatic juice output of most grafts stopped after the 9th posttransplant day.In group 3,pancreatic juice amylase of the grafts remained in a high level.The TNF-α level of pancreatic juice in untreated animals was increased markedly at the 4th posttransplant day.The amylase of pancreatic juice was decreased bv 86% 3 days before a marked increase of blood glucose was noted.The marked increase of TNF-α level in pancreatic juice was noted 5 days before the increase of bloOd glucose.Conclusions The TNF-α level of pancreatic juice was a marker of acute pancreatic allograft rejection earlier than the amylase of pancreatic juice.The increase of blcxxl glucose was the latest marker of pancreas allograft rejection.The triple dmg in inwnunosuppression(CsA,TW and MP)can well prevented the acute pancreas allograft rejection. Key words: Pancreas transplantation; Graft rejection; Diagnosis