Procurement of the human pancreas for pancreatic islet transplantation from marginal cadaver donors.
BACKGROUND
Recent advances in pancreatic islet transplantation (PIT) have contributed significantly to the treatment of patients with type 1 diabetes. The specific aim of this study was to develop an effective technique for the procurement of pancreas for PIT from nonheart-beating-donor (NHBDs).


METHODS
Between January 2004 and August 2004, eight human pancreata were procured and processed for isolation of islets at a cell processing center. After confirmation of brain death status, a double balloon catheter was inserted to prevent warm ischemic damage to the donor pancreas by using an in situ regional organ cooling system that was originally developed for procurement of kidneys. The catheter position of the cooling system was modified specifically for the pancreas and kidney. Furthermore, we worked in cooperation with a kidney procurement team to protect the pancreas during kidney procurement.


RESULTS
Warm ischemic time could be controlled with the modified in situ regional cooling system at 3.0 +/- 0.8 min (mean +/- SE). The operations for procurement of the kidneys and pancreata lasted 45.6 +/- 3.6 min and 10.6 +/- 1.8 min, respectively. Islet yield per isolation was 444,426 +/- 35,172 IE (islet equivalent). All eight cases met the criteria for PIT based on the Edmonton protocol.


CONCLUSIONS
We developed a novel procurement technique in cooperation with our kidney procurement team. This protocol for the procurement of pancreas and kidney from a NHBD enabled us to transplant islets into a type 1 diabetic patient and kidney into a renal failure patient.
Nagata
Hideo
H
Department of Transplantation and Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan. hnagata@kuhp.kyoto-u.ac.jp
Matsumoto
Shinichi
S
Okitsu
Teru
T
Iwanaga
Yasuhiro
Y
Noguchi
Hirofumi
H
Yonekawa
Yukihide
Y
Kinukawa
Tsuneo
T
Shimizu
Tomohiro
T
Miyakawa
Shuichi
S
Shiraki
Ryoichi
R
Hoshinaga
Kiyotaka
K
Tanaka
Koichi
K
D002102:Cadaver; D002404:Catheterization; D005260:Female; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D009927:Tissue and Organ Procurement