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Pancreatic transplantation is still partly experimental and involves a variety of problems, such as handling of exocrine secretion, prevention of arterial thrombosis of the graft, and immunosuppres­ sion. Aiming at the best method of handling exocrine secretion and at prevention of thrombosis, pancreas transplantation with the duodenum (pancreaticoduodenal transplantation) was performed in eighteen pairs of ·mongrel dogs. Nine recipients (control group) were transplanted without im­ munosuppression, and the other nine were immunosuppressed with cyclosporin A (CsA group) after transplantation. Five dogs which died of intussusception, strangulation, hemorrhagic pancrea­ tities etc. were not evaluated in this study. In the control grouP,. survivals were 16, 14,8,7 and 6_ days; in the CsA group, survivals were >395, >150, 89, 70, 25, 18, 18, and 12 days, respectively. In the CsA group there were two long-term surviving dogs without rejection; and the grafted pan­ creas of one of these dogs was judged to be almost normal in exocrine and endocrine glands micro­ scopically from a specimen biopsied on the 260th postoperative day. This result is worthy of special mention in the animal experiment. esA was more effective in prolonging survival of the dogs which received pancreaticoduodenal transplantation when compared with conventional immunosuppression. In the pancreaticoduodenal transplantation with aortic cuff, which was expected to increase the blood flow of the graft followed by a decrease in the incidence of thrombosis, there were 6 cases with thrombosis of the graft among 13 recipients. It was concluded, therefore, that CsA is effective in prolonging the survival of dogs which receive pancreaticoduodenal transplantation with physi­ ological drainage of exocrine secretion into the duodenum, but that prevention of thrombosis by means of adequate anti-thrombosis treatment is essential.

Canine pancreatic allotransplantation with duodenum (pancreaticoduodenal transplantation) using cyclosporin A.