Logistics and transplant coordination activity in the GRAGIL Swiss-French multicenter network of islet transplantation.
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.
Kempf
Marie-Claude
MC
Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.
Andres
Axel
A
Morel
Philippe
P
Benhamou
Pierre-Yves
PY
Bayle
François
F
Kessler
Laurence
L
Badet
Lionel
L
Thivolet
Charles
C
Penfornis
Alfred
A
Renoult
Edith
E
Brun
Jean-Marcel
JM
Atlan
Catherine
C
Renard
Eric
E
Colin
Cyrille
C
Milliat-Guittard
Laure
L
Pernin
Nadine
N
Demuylder-Mischler
Sandrine
S
Toso
Christian
C
Bosco
Domenico
D
Berney
Thierry
T
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