To the Editor:
Cattral et al. have compared portal venous (20 patients) versus systemic venous (20 patients) drainage of pancreatic grafts. 1 The blood glucose values during oral glucose tolerance test were similar in the two groups. Fasting insulin levels were lower in the portal venous drainage.
Twelve years ago, we performed an experimental study 2 in diabetic rats to compare portal versus caval drainage. In portal-grafted rats glucose tolerance was strictly normalized, with a plasma insulin profile similar to that observed in normal rats. In caval-grafted rats, a delayed plasma insulin peak was observed with some abnormalities in the plasma glucose profile, with the late plasma glucose concentrations being higher than a in portal-grafted animals (P < .01) The extent of pancreatic fibrosis was similar in both groups. These results demonstrated a superiority of portal venous drainage compared with caval drainage.
Michel Huguier, MD
References
- 1.Cattral MS, Bigam DL, Hemming AW, et al. Portal venous and entric exocrine drainage versus systemic venous and bladder exocrine drainage of pancreas grafts. Clinical outcome of 40 consecutive transplants recipients. Ann Surg 2000; 232: 688–695. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Lugagne PM, Reach G, Houry S, et al. Portal versus peripheral venous drainage in segmental pancreatic transplantation in diabetic rats. Transplantation 1989; 47: 420–423. [DOI] [PubMed] [Google Scholar]