Islet isolation and transplantation outcomes of pancreas preserved with University of Wisconsin solution versus two-layer method using preoxygenated perfluorocarbon.
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.
Kin
Tatsuya
T
Clinical Islet Transplant Program, University of Alberta and Capital Health, Edmonton, Alberta, Canada.
Mirbolooki
Mohammadreza
M
Salehi
Payam
P
Tsukada
Manabu
M
O'Gorman
Doug
D
Imes
Sharleen
S
Ryan
Edmond A
EA
Shapiro
A M James
AM
Lakey
Jonathan R T
JR
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
D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D000255:Adenosine Triphosphate; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose