title: Logistics and transplant coordination activity in the GRAGIL Swiss-French multicenter network of islet transplantation.
abstract: BACKGROUND
  Since the Edmonton trial in 2000, increasing numbers of transplant centers have been implementing islet transplantation programs. Some institutions have elected to associate in multicenter networks, such as the Swiss-French GRAGIL (Groupe Rhin-Rhône-Alpes-Genève pour la Transplantation d'Ilots de Langerhans) consortium.
  
  
  METHODS
  All pancreata offers to the University of Geneva Cell Isolation and Transplantation Center from within the network in 2002 and 2003 were reviewed. Islet preparations were attributed to the most suitable recipient on a centrally managed waiting list. All shipments were performed by ambulance in less than 5 hr.
  
  
  RESULTS
  Over the period of study, 260 pancreata were offered, from a total of 1,304 cadaveric donors in the four allocation regions (20%). Fifty-two patients were on the waiting list at any time during this 2-year period. The percentage of organs offered varied in the range of 0.5% to 42%, depending on region of origin, with a correlation with number of patients on the waiting list in each region. Of these, 104 (40%) were accepted for processing. Ninety-two pancreata were actually processed, resulting in 42 islet preparations being transplanted. The number of international equivalents of transplanted preparations was 378,500+/-16,000 versus 165,400+/-15,400 (P<0.0001) for nontransplanted preparations. Total cold ischemia time was 6+/-0.3 hr for transplanted preparations versus 6.7+/-0.4 hr for nontransplanted preparations (not significant). CONCLUSIONS.: A high rate of pancreas offers, successful isolation, and islet transplantation can be achieved in multicenter networks such as GRAGIL. Such an approach can expand both the donor pool and the recipient population.
authors.affiliation: Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Kempf
authors.forename: Axel
authors.initials: A
authors.lastname: Andres
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Benhamou
authors.forename: François
authors.initials: F
authors.lastname: Bayle
authors.forename: Laurence
authors.initials: L
authors.lastname: Kessler
authors.forename: Lionel
authors.initials: L
authors.lastname: Badet
authors.forename: Charles
authors.initials: C
authors.lastname: Thivolet
authors.forename: Alfred
authors.initials: A
authors.lastname: Penfornis
authors.forename: Edith
authors.initials: E
authors.lastname: Renoult
authors.forename: Jean-Marcel
authors.initials: JM
authors.lastname: Brun
authors.forename: Catherine
authors.initials: C
authors.lastname: Atlan
authors.forename: Eric
authors.initials: E
authors.lastname: Renard
authors.forename: Cyrille
authors.initials: C
authors.lastname: Colin
authors.forename: Laure
authors.initials: L
authors.lastname: Milliat-Guittard
authors.forename: Nadine
authors.initials: N
authors.lastname: Pernin
authors.forename: Sandrine
authors.initials: S
authors.lastname: Demuylder-Mischler
authors.forename: Christian
authors.initials: C
authors.lastname: Toso
authors.forename: Domenico
authors.initials: D
authors.lastname: Bosco
authors.forename: Thierry
authors.initials: T
authors.lastname: Berney
mesh_terms: D000328:Adult; D002423:Cause of Death; D002469:Cell Separation / Q000379:methods; D005602:France; D006801:Humans; D007515:Islets of Langerhans / Q000166:cytology; D016381:Islets of Langerhans Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D040841:Resource Allocation; D013557:Switzerland; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D016896:Treatment Outcome