THE EFFECT OF FASTING AND EXOGENOUS ADENOSINE ON ATP TISSUE CONCENTRATION AND VIABILITY OF CANINE PANCREAS GRAFTS DURING PRESERVATION BY THE 2-LAYER METHOD

We have demonstrated a direct correlation between a high ATP level in a canine pancreas graft after preservation by the two-layer method and good posttransplant outcome. The purpose of this study was to examine the effect of fasting and exogenous adenosine on the ATP tissue level and viability of the canine pancreas graft during preservation by the two-layer method. Graft viability was judged by graft survival follow ing autotransplantation. Maintenance of normoglycemia for 5 days post- transplant was considered graft survival. The pancreas was harvested f rom either 72-hr-fated (n=3) or -fed dogs (n=4) and preserved by the t wo-layer (Euro-Collins' solution [EC]/perfluorochemical [PFC]) method for 24 hr. Graft survival rates in fed and fasted groups were 4/4 (100 %) and 3/3 (100%), respectively. There was no significant difference i n ATP tissue concentrations between the two groups (7.48+/-0.55 vs. 7. 03+/-0.74 mu mol/g dry wt, NS). The pancreas was subjected to 60 min w arm ischemia and then was preserved by the two-layer method using EC o r EC containing 5 mM adenosine for 24 hr. Without adenosine, graft sur vival rate was 0/3 (0%) and ATP tissue levels were not changed during preservation (1.62+/-0.26 vs. 1.56+/-0.40 mu mol/g dry wt, NS). Howeve r, provision of adenosine to the graft during preservation led to the restoration of ATP tissue levels (1.90+/-0.54 vs. 8.13+/-0.98 mu mol/g dry wt, P<0.01) in 4 of 5 grafts, and these grafts functioned immedia tely and maintained normoglycemia after transplantation. Graft surviva l rate was 4/5 (80%). One of 5 grafts, however, did not survive, and t he ATP tissue level was not adequately recovered during preservation c ompared with viable grafts (3.67 vs. 8.13+/-0.98 mu mol/g dry wt). Thi s study clearly demonstrates that the nutritional state of the donor h as no influence on the ATP tissue level and viability of the graft dur ing 24-hr preservation by the two-layer method. On the other hand, pro vision of adenosine to the graft during preservation stimulates ATP sy nthesis and improves the viability of the ischemically damaged pancrea s.