title: Islet isolation and transplantation outcomes of pancreas preserved with University of Wisconsin solution versus two-layer method using preoxygenated perfluorocarbon.
abstract: BACKGROUND
  Previous small clinical trials indicate that the two-layer method (TLM) for pancreas preservation improves islet isolation outcome. However, the effect of TLM has not been evaluated in large-scale study. In addition, a direct benefit of TLM on islet transplantation outcome has not been addressed in the setting of any randomized controlled trials.
  
  
  METHODS
  Between April 2003 and October 2005, human pancreata from brain-dead donors were preserved by TLM using preoxygenated perfluorocarbon (n = 75) or in University of Wisconsin (UW) solution (n = 91) prior to islet isolation. Islet isolation and transplantation outcomes were compared between the two groups.
  
  
  RESULTS
  We did not find any significant differences in adenosine triphosphate content in pancreatic tissue after preservation, pre and postpurification islet yields, in vitro insulin secretory function, or utilization ratio of transplantation between the two groups. Transplanted mass and functional viability of islet isolated from TLM-preserved pancreas were similar to those from UW-preserved pancreas. Patients receiving the TLM-islet or the UW-islet showed a marked decrease in insulin requirement after transplantation. However, no significant difference was observed in a decrease in insulin requirement between patients receiving the TLM-islet and the UW-islet.
  
  
  CONCLUSIONS
  No beneficial effect of TLM on islet isolation and transplantation outcomes was observed. Our findings bring into question the true merit of routine use of TLM prior to islet isolation.
authors.affiliation: Clinical Islet Transplant Program, University of Alberta and Capital Health, Edmonton, Alberta, Canada.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kin
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Mirbolooki
authors.forename: Payam
authors.initials: P
authors.lastname: Salehi
authors.forename: Manabu
authors.initials: M
authors.lastname: Tsukada
authors.forename: Doug
authors.initials: D
authors.lastname: O'Gorman
authors.forename: Sharleen
authors.initials: S
authors.lastname: Imes
authors.forename: Edmond A
authors.initials: EA
authors.lastname: Ryan
authors.forename: A M James
authors.initials: AM
authors.lastname: Shapiro
authors.forename: Jonathan R T
authors.initials: JR
authors.lastname: Lakey
mesh_terms: D000241:Adenosine; D000255:Adenosine Triphosphate / Q000032:analysis; D000328:Adult; D000493:Allopurinol; D001926:Brain Death; D002102:Cadaver; D002469:Cell Separation / Q000379:methods; D005260:Female; D005978:Glutathione; D006801:Humans; D007328:Insulin; D007515:Islets of Langerhans / Q000166:cytology*; D016381:Islets of Langerhans Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D010179:Pancreas / Q000166:cytology; D010313:Partial Pressure; D011887:Raffinose; D014019:Tissue Donors / Q000706:statistics & numerical data
chemical_list: D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D000255:Adenosine Triphosphate; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose