| Objective: 1. to establish a rat model of pancreas-kidney transplantationwith facilitated performance, considerable duplicability and viability, so as to beused in basic research on simultaneous pancreas-kidney(SPK). 2. to investigatethe therapeutic effect of SPK on the rat model with diabetes mellitus.Methods: 1. Using male SD rats as donors and recipients, donor operation:we harvested the right kidney, pancreas and duodenum from the donor, andanastomosed firstly the portal vein to inferior vena cava (IVC) beneath kidneywith a cuff technique in the conservation solution; recipient operation:sequentially anastomosed donor's IVC to the recipient's IVC, donor's abdominalaorta to the recipient's abdominal aorta, donor's duodenum to recipient's jejunum3-4cm beneath the Treitz ligament in a side-to-side manner, and finallyanastomosed donor's bladder patch with unilateral ureter to recipient's bladderwith a running suture. 2. Fifteen SD rats with DM were performed SPK andsimultaneously removed of their bilateral kidneys one week after STZ treatment.Among them, 5 were used for pathological analysis at days 3,30,60 and 90 afterSPK, and 10 were used for blood sugar and serum creatinine monitoring 1 weekbefore and after DM formation, as well as 3,30 and 60 days after SPK. Inaddition, urine volume was monitored 1 week before and after DM formation, aswell as 1,2,3,4,5 and 6 days after SPK while body weight was monitored 1 weekbefore and after DM formation, as well as 1,2,3 and 4 weeks after SPK. Theoutcome data were analyzed through paired-T test.Results: 1. A total operation time of 180 minutes, including 50 minutes ofcold ischemia while no hot ischemia, is made up of (70±10) minutes forharvesting of allograft, (3±1) minutes for cuff technique, (80±10) minutes forrecipient and 30minutes for vascular anastomoses. 90% out of 30 rats survivedthe surgery while 80% still survived 15 days after surgery. The reasons of deathwere intraoperative hemorrhage (2 cases), urinary tract obstruction (2 cases),intestinal obstruction (1 case) and abdominal infection (1 case). 2. Comparedwith the data achieved before DM formation, blood sugar, serum creatinine andurine volume in the DM rats after successful SPK exhibited little significance(P>0.05). Related to data achieved at the state of DM, blood sugar and urinevolume in the transplanted rats showed great significance(P<0.05)while serumcreatinine did not(P>0.05)after DM formation. In addition, body weightunderwent little change 1 week before and after surgery while recoveredgradually from 14th postoperative day, in comparison to the data in state of DM.Reject reaction, which was found more severe in kidney than in other organs, wassequentially observed in kidney, pancreas and then duodenum after one month ofsurvival according to the pathological findings. Conclusions: 1. High viability while few complications were found in themodel of pancreas-kidney transplantation. 2. successful SPK can therapy a ratwhich was suffering from diabetes-mellitus and uraemia. 3. after SPK, thesequential rejection was kidney, pancreas and then duodenum, and the rejectionof kidney was more severe than other organs.
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