Liver and Pancreatic Diseases

Biography

Dr. Very Coulic born in Belgium (1936), and has done primary and secondary school in Belgium and medical formation in Brussels University, Medicine Faculty (2.5 years) then Moscow 1st Medicine Institute named by IM Sechenov. There Ph.D. and High School Agreation degrees in Surgery. Docent in 1971, professor for Human Anatomy in 1971. Assistant, scientific worker, and teacher successively in the 1st Medicine Institute, the Academic Laboratory of organ and tissue Transplantation, at the People Friendship University.

Abstract

Background. Up to now, the general opinion is that vascular connections of a graft to its recipient are necessary and enough to ensure the graft satisfactory function. Nevertheless, a degradation of the functional performances of the grafts, especially pancreas ones, was observed in post-operation late delays in the absence of evident chronic rejection process.

The benefit of surgical reinnervation of syngeneic intestinal and pancreatic grafts was previously proved in experiments on dogs and rats: acceleration of functional recovery, good morphological and physiological results in late observation delays.

The aim of the present pilot study was to investigate the technical feasibility of surgical reconstruction of the nervous connections between graft and recipient during transplantation surgery, to evaluate the eventual risk and to test the short delay results.

Material and methods. A total of 30 patients were involved after similar kidney or pancreas transplantation: 10 with surgical reinnervation, 20 for control without it. Observation delay: up to 12 months. Post-transplantation investigations were provided as usual.

Results. A technique of suturing nervous plexus of the graft with the recipient sacral plexus nerves was elaborated. The manipulation did not exceed 10 min after decamping of the recipient blood vessels. No surgical or post-operation complication was registered. The early post-operation course was easy.

Conclusion. The first results of the surgically directed reinnervation of pancreas and kidney grafts were encouraging. The long delay functional results (5 years and more) are necessary to evaluate the possible benefit of the immediate reconstruction of both vascular and nervous connections between grafts and recipients, as well as a physiologic proof of their neuro reflex links restoration.