A randomized trial in simultaneous pancreas-kidney transplantation: portal versus systemic venous drainage of the pancreas allograft.
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The progression of diabetic retinopathy after combined pancreatic and kidney transplantation was studied in eight patients for 12 to 49 months. Four patients who had rapid pancreatic graft failure constituted a control group for comparison with four patients who retained functioning grafts. Using Fisher's exact probability test, the authors found no posttransplantation difference between the two groups in visual acuity lost, severity of diabetic macular edema, extent of capillary closure, progression of preretinal gliosis, development of disc or preretinal neovascularization, or worsening of the severity of the retinopathy. Achievement of normoglycemia by pancreatic transplantation is not effective in halting the progression of diabetic retinopathy in patients who already have severe diabetic microangiopathy joined the current follow-up.
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Adipose tissue was removed from five-day old chickens after a) an overnight fast, b) total pancreatectomy and c) partial evisceration and digested with collagenase. The adipocytes were incubated with pancreatic glucagon (Novo) and the glycerol released into the medium taken as the index of lipolytic activity. A moderate fast, while being without effect on basal lipolysis, slightly decreased adipocyte sensitivity to glucagon. Pancreatectomy and evisceration significantly reduced both basal lipolysis and the response to glucagon: the impairment was most evident just at the concentration found in the plasma of such operated animals. It seems clear that normal lipolysis is under the control not only of pancreatic factors, but also of those of intestinal origin, and can only proceed normally when both are present.
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