Dmitriev I, Oganesyan M, Popova A, Orlov E, Sinelnikov M, Zharikov Y. Anatomical basis for pancreas transplantation via isolated splenic artery perfusion: A literature review. World J Clin Cases 2022; 10(35): 12844-12853 [PMID: 36569006 DOI: 10.12998/wjcc.v10.i35.12844]
Corresponding Author of This Article
Yury Zharikov, MD, PhD, Associate Professor, Surgeon, Department of Human Anatomy, Sechenov First Moscow State Medical University (Sechenov University), Mokhovaya Street, 11s10, Moscow 125009, Russia. dr_zharikov@mail.ru
Research Domain of This Article
Anatomy & Morphology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ilya Dmitriev, Department of Pancreas and Kidney Transplantation, N.V. Sklifosovsky Research Institute for Emergency Care, Moscow 107045, Russia
Marine Oganesyan, Antonina Popova, Egor Orlov, Mikhail Sinelnikov, Yury Zharikov, Department of Human Anatomy, Sechenov First Moscow State Medical University (Sechenov University), Moscow 125009, Russia
Mikhail Sinelnikov, Department of Oncology, Radiotherapy and Reconstructive Surgery, Sechenov First Moscow State Medical University (Sechenov University), Moscow 119048, Russia
Mikhail Sinelnikov, Laboratory of clinical morphology, Research Institute of Human Morphology, Moscow 117418, Russia
Author contributions: Dmitriev I contributed to conceptualization, supervision, visualization and manuscript first draft preparation; Oganesyan M contributed to supervision, data acquisition and manuscript first draft preparation; Popova A contributed to data acquisition, visualization, manuscript writing and editing; Orlov E contributed to data acquisition, formal analysis, methodology, manuscript writing and editing; Sinelnikov M contributed to visualization, formal analysis, manuscript writing, review and editing; Zharikov Y contributed to supervision, conceptualization, manuscript first draft preparation, review and editing; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest in the writing and preparation of this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yury Zharikov, MD, PhD, Associate Professor, Surgeon, Department of Human Anatomy, Sechenov First Moscow State Medical University (Sechenov University), Mokhovaya Street, 11s10, Moscow 125009, Russia. dr_zharikov@mail.ru
Received: August 19, 2022 Peer-review started: August 19, 2022 First decision: September 30, 2022 Revised: October 10, 2022 Accepted: November 30, 2022 Article in press: November 30, 2022 Published online: December 16, 2022
Abstract
The variability of vascular anatomy of the pancreas underlines the difficulty of its transplantation. Research regarding the consistency of anatomical variations shows splenic arterial dominance in most cases. This can significantly improve transplantation success. A systematic literature review was performed according to the quality standards described in the AMSTAR measurement tool and the PRISMA guidelines. We valuated existing literature regarding the vascularization and blood perfusion patterns of the pancreas in terms of dominance and variability. The collected data was independently analyzed by two researchers. Variance of vascular anatomy was seen to be underreported in literature, though significant findings have been included and discussed in this study, providing valuable insight into the dynamics of pancreatic perfusion and feasibility of transplantation on several different supplying arteries. The splenic artery (SA) has a high percentage of consistency in all found studies (over 90%). High frequency of anastomoses between arterial pools supplying the pancreas can mediate sufficient blood supply through a dominant vessel, such as the SA, which is present in most cases. Pancreatic transplantation with isolated SA blood supply can provide sufficient arterial perfusion of the pancreas for stable transplant viability due to high anatomical consistency of the SA and vast communications with other arterial systems.
Core Tip: We summarize existing findings on the variant anatomy of pancreatic blood supply to justify, from an anatomical point of view, the possibility of pancreatic transplantation with isolated splenic artery blood supply (ISABS). The blood supply of the pancreas is characterized the absence of a single large source arterial inflow, and an intimate communication with arteries of the surrounding organs. The practical significance of anatomical features of blood supply of cephalocervical and corporocaudal segments of the pancreas and well-described numerous arterial collaterals and anastomoses of these areas are the basis for establishing collateral circulation in cases of reduced blood flow through one or more arteries or in case of pancreatic transplantation with ISABS.
