Deterioration of Islet β-Cell Function After Hemipancreatectomy in Dogs

The metabolic consequences of hemipancreatectomy in living pancreas donors were tested in a dog model in which a 50% lobe-specific pancreatectomy was performed. Removal of the dorsal lobe (analogous to a donor, n = 4) resulted in a progressive increase in fasting glucose during 12 mo from 5.32 ± 0.16 to 8.17 ± 0.28 mM and a decrease in fasting insulin from 54 ± 3 to 6.0 ± 2.4pM and glucose clearance (K_g) from 3.00 ± 0.22 to 1.00 ± 0.06 mM. Removal of the ventral lobe (analogous to a recipient, n = 5)did not result in a change in fasting glucose or K_g during 12 mo, although fasting insulin was reduced from 36.0 ± 1.8 to 18.00 ± 1.93 pM. In vitro perfusion of the remnants after 1 yr showed a deterioration in glucose-stimulated insulin secretion (5–11 mM) by the dorsal remnant (18 ± 11 vs., 232 ± 37%) and the ventral remnant (2.6 ± 19 vs. 87 ± 13%). The dorsal remnant had a higher response than the ventral remnant (46 ± 23 vs. −16 ± 10%, respectively) to severe hyperglucosuria (11–27.7 mM). Insulin content was unchanged in the dorsal remnant (224 ± 16 vs. 180 ± 14μg/g), but was reduced in the ventral remnant (65 ± 14 vs. 154 ± 15μg/g). Invitro insulin pulse intervals were reduced in both remnants (5.3 ± 0.2 min vs. control 7.00 ± 0.18 min). Because of the above effects on the donor when the dorsallobe is removed, the continued use of hemipancreatectomy as a source of transplantable tissue must be questioned.