title: Possibility of islet transplantation from a nonheartbeating donor pancreas resuscitated by the two-layer method.
abstract: BACKGROUND
  The shortage of cadaveric donors is a problem in islet transplantation, and recent improvements in this field have led to renewed interest in the use of nonheartbeating (NHB) donors. NHB donor pancreata that could provide a significant source for islet transplantation are associated with warm ischemic injury. We tested whether the two-layer method (TL) could improve islet yield and function from damaged pancreata after warm ischemia (WI).
  
  
  METHODS
  Lewis rats were divided into six groups. In groups 1 to 3, rats were subjected to 0, 30, and 45 minutes of WI, respectively. Islets were isolated immediately (subgroup a) or after 3-hour preservation with TL (subgroup b). Isolated islets were assessed in terms of islet yield and in vivo function. We also assessed the pancreatic tissue ATP concentration before isolation and distended pancreata morphologically after chemical digestion by H&E staining.
  
  
  RESULTS
  Islet yield decreased significantly after 30 minutes of WI in group 2a, whereas TL preservation doubled this decreased yield in group 2b. Forty-five minutes of WI resulted in nearly no islet yield in both groups 3a and 3b. The success rates of transplantation in groups 1a, 1b, 2a, and 2b were 100%, 100%, 0%, and 75%, respectively. Increased tissue ATP levels and alleviation of morphological islet damage were observed in group 2b.
  
  
  CONCLUSIONS
  These results demonstrated that pancreata damaged from 30-minute WI were restored by 3-hour TL preservation. TL may allow the selective use of NHB donors as an alternative source for islet transplantation.
authors.affiliation: Division of Gastroenterological Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Tanioka
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sakai
authors.forename: Keitaro
authors.initials: K
authors.lastname: Kakinoki
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Goto
authors.forename: Shiri
authors.initials: S
authors.lastname: Li
authors.forename: Takuro
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujino
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kuroda
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D006323:Heart Arrest; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D008297:Male; D051379:Mice; D010179:Pancreas / Q000378:metabolism / Q000473:pathology / Q000502:physiology* / Q000601:surgery*; D051381:Rats; D014019:Tissue Donors; D014183:Transplantation, Heterologous / Q000379:methods
chemical_list: D000255:Adenosine Triphosphate