Impairment of bone and mineral metabolism after pancreatic transplantation: observations in syngeneic rats.

OBJECTIVE

To find out whether transplantation of the duodenum and pancreas results in osteopathy in immunotolerant recipient rats.

DESIGN

Prospective study.

SETTING

University hospital, Germany.

ANIMALS: 30 male Lewis rats weighing about 315 g.

INTERVENTIONS: Laparotomy alone (n = 10, control), or transplantation by one of three techniques: ectopic extraportal (EE, n = 5), ectopic intraportal (EI, n = 7), or orthotopic intraportal (OI, n = 8).

MAIN OUTCOME MEASURES: Body weight; changes in mineral and bone metabolism, bone density and ash, and the breaking force of bone.

RESULTS

Rats were followed for 133 plus or minus 3 days. Compared with the control group the rats that had undergone transplantation had delayed gain in body weight and the final weight was reduced. Urinary glucose and basal serum glucose and insulin concentrations were unaffected, but that of pancreatic polypeptide was low. In the transplanted groups intestinal absorption of calcium and phosphorus and serum concentrations of calcium and parathyroid hormone were within reference ranges. Serum magnesium (EI and OI) and phosphorus (EI) concentrations, and the urinary calcium (FE) and phosphorus (EI) concentrations, and the urinary hydroxyproline:serum osteocalcin ratio (FE, and EI) were significantly higher than in controls (p < 0.01).

CONCLUSIONS

Transplantation failed to disturb glucometabolic functions and intestinal mineral absorption but was associated with an osteopathy which showed itself in high bone resorption and reduced bone phosphorus and magnesium concentrations. The osteopathy developed irrespective of the technique of reconstruction of the digestive tract and so may be caused by division of intestinal nerves or their incomplete regeneration.