title: The use of non-heart-beating donors for isolated pancreatic islet transplantation.
abstract: Recent improvements in isolated islet transplantation indicate that this therapy may ultimately prove applicable to patients with type I diabetes. An obstacle preventing widespread application of islet transplantation is an insufficient supply of cadaveric pancreata. Non-heart-beating donors (NHBDs) are generally not deemed suitable for whole-organ pancreas donation and could provide a significant source of pancreata for islet transplantation. Isolated pancreatic islets prepared from 10 NHBDs were compared with those procured from 10 brain-dead donors (BDDs). The success of the isolation for the two groups was analyzed for preparation purity, quality, and recovered islet mass. The function of NHBD and BDD islets was evaluated using in vitro and in vivo assays. On the basis of the results of this analysis, an NHBD isolated islet allograft was performed in a type I diabetic. The recovery of islets from NHBDs was comparable to that of control BDDs. In vitro assessment of NHBD islet function revealed function-equivalent BDD islets, and NHBD islets transplanted to non-obese diabetic-severe combined immunodeficient (NOD-SCID) mice efficiently reversed diabetes. Transplantation of 446,320 islet equivalents (IEq) (8,500 IEq/kg of recipient body weight) from a single NHBD successfully reversed the diabetes of a type I diabetic recipient. Normally functioning pancreatic islets can be isolated successfully from NHBDs. A single donor transplant from an NHBD resulted in a state of stable insulin independence in a type I diabetic recipient. These results indicate that NHBDs may provide an as yet untapped source of pancreatic tissue for preparation of isolated islets for clinical transplantation.
authors.affiliation: Department of Surgery, University of Pennsylvania Health System, Philadelphia 19104, USA. James.Markmann@UPHS.Upenn.edu
authors.forename: James F
authors.initials: JF
authors.lastname: Markmann
authors.forename: Shaoping
authors.initials: S
authors.lastname: Deng
authors.forename: Niraj M
authors.initials: NM
authors.lastname: Desai
authors.forename: Xiaolun
authors.initials: X
authors.lastname: Huang
authors.forename: Ergun
authors.initials: E
authors.lastname: Velidedeoglu
authors.forename: Adam
authors.initials: A
authors.lastname: Frank
authors.forename: Chengyang
authors.initials: C
authors.lastname: Liu
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Brayman
authors.forename: Moh Moh
authors.initials: MM
authors.lastname: Lian
authors.forename: Bryan
authors.initials: B
authors.lastname: Wolf
authors.forename: Ewan
authors.initials: E
authors.lastname: Bell
authors.forename: Marko
authors.initials: M
authors.lastname: Vitamaniuk
authors.forename: Nicolai
authors.initials: N
authors.lastname: Doliba
authors.forename: Franz
authors.initials: F
authors.lastname: Matschinsky
authors.forename: Eileen
authors.initials: E
authors.lastname: Markmann
authors.forename: Clyde F
authors.initials: CF
authors.lastname: Barker
authors.forename: Ali
authors.initials: A
authors.lastname: Naji
mesh_terms: D000328:Adult; D000818:Animals; D001926:Brain Death; D002102:Cadaver; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007515:Islets of Langerhans / Q000502:physiology; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D051379:Mice; D016513:Mice, SCID; D008875:Middle Aged; D014019:Tissue Donors