Best conditions of hypothermic machine perfusion of the porcine pancreas.

Mourik, H.G.J. van (2013) Best conditions of hypothermic machine perfusion of the porcine pancreas. thesis, Medicine.

Text MourikvanHGJ.pdf Restricted to Registered users only Download (2MB)

Abstract

Background: In the Netherlands approximately 100,000 patients are diagnosed with diabetes mellitus type 1. For most of these patients the treatment with insulin injections is sufficient in lowering the glucose level in the blood. For some patients however it is difficult to dose the proper quantity of insulin, sometimes resulting in hypoglycaemia. To prevent hypoglycaemic states in patients research is done on transplantation of the islets of Langerhans. Oxygen shortage during preservation causes damage to the islets which is why more than one donor pancreas is needed for a successful transplantation. A promising preservation method for better islets viability and functionality is hypothermic machine perfusion (HMP) of the pancreas. The existing machine perfusion pumps are not suitable for the pancreas. A new machine perfusion pump for the pancreas should be designed and the optimal perfusion pressure of this machine should be determined. Methods and materials: Eleven porcine pancreases were perfused for a period of two hours. The pancreases were perfused with pressures of 10, 20, 40 and 70 mm Hg. Before and after perfusion, biopsies were taken for analysis of the quality of the perfusion and for the ATP content. Samples of the perfusion fluid were taken for amylase, lipase and LDH measurements. Results: A pumping system for HMP of the pancreas was developed. With this system, the pancreas could be perfused with an oxygenised perfusion fluid on a desired pressure. The temperature could be lowered to 6˚C. A pressure of 10 mm Hg caused incomplete perfusion of the pancreas. Perfusion with a pressure of 20 mm Hg perfused the complete pancreas; most of the cells were vital. Pressures of 40 and 70 mm Hg caused oedema in the pancreas tissue. Most of the cells were dead, as is visible on the viability staining. Conclusion: The design of the pump is suitable for HMP of the pancreas. A limitation of the system is that it is not portable and contains only one pump for perfusion of two arteries. The ideal perfusion pressure for HMP of the pancreas is 20 mm Hg. A perfusion pressure of 10 mm Hg is too low for HMP of the pancreas. Perfusion pressure of 40 mm Hg or 70 mm Hg is too high and caused damage to the pancreatic tissue.

Item Type:	Thesis (Thesis)
Supervisor name:	Krikke, Drs. C. and Leemkuil, Drs. M. and Leuvenink, Dr. H.G.D.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:58
Last Modified:	25 Jun 2020 10:58
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1885

Actions (login required)

View Item