380 
SURGERY AND TRANSPLANTATION 
GLUCOSE 
mg/iooml 
. 180 N: 3-17 
120'n: 5-15 
90' N=17-40 
■ o'n= 6-24 
MINUTES AFTER GLUCOSE 
Figure 11. — Glucose tolerance curves demonstrate 
greater sensitivity to the effects of normothermic is- 
chemia on the canine pancreas. 
present technique favored by the author is illus- 
trated in Figure 13. 
To date, a total of twenty-four transplants of 
the pancreas have been carried out in man at 
nine centers (Table II). The grafts have been 
both segmental and pancreatico-duodenal, with 
and without an associated renal allograft. Maxi- 
mal survival has been twelve months. Those 
surviving six months or more with functioning 
Table II. — Pancreas Transplantation in Man 
Number of 
Graft Survival 
Type of Transplant 
Cases 
(Range) 
Pancreas (Body and Tail) 
5 
6 Days— 120 Days 
Pancreas/Kidney 
2 
59 Days— 3 Months -f- 
Pancreatico-Duodenal 
3 
7 Days — 2 Months 
Pancreatico-Duodenal/Kidney 
14 
5 Days — 12 Months 
lUac -vein 
ligatcd 
Pancreatic duct 
Heated 
Figure 12. — Technique employed in the first human 
pancreatic allograft, December 17, 1966. Note the 
vascular connections and the ligated pancreatic duct. 
oSv, 
Left 
kidney 
Figure 13. — Technique for pancreatico-duodenal trans- 
plantation in man for juvenile diabetes with renal 
failure. Note the en bloc extirpation of the gland. 
The renal transplant is depicted using the technique 
usually employed. The pancreas is transplanted with 
a Carrel patch of aorta containing the origins of the 
celiac and superior mesenteric arteries. 
grafts have clearly demonstrated that excellent 
control of sugar metabolism could be obtained. 
None have survived long enough to determine 
the effect on angiopathy. However, none of the 
longer survivors exhibited worsening of their 
angiopathy, especially with respect to retinal 
vasculature. 
The clinical experience has underlined some 
of the principles learned from the canine expe- 
riments. The "no touch" technique has proven 
to be indispensable to removing a gland which 
will continue to function normally in the 
recipient.'° Immediate post-transplant hyper- 
insulinemia has been seen in the human as well 
as the dog. The only present survivor of pan- 
creas transplantation in man received a pan- 
creas without duodenum followed by a renal al- 
lograft at a second operation. Doctors Veith and 
Gliedman employed an ingenious device to pro- 
vide for pancreatic duct drainage. They anasto- 
