The effect of donor factors on human islet yield and their in vivo function.
BACKGROUND
A major problem in the islet field is the high selectivity exercised in accepting cadaveric pancreas for islet isolation. This practice is based on experience that indicates that islet yield and posttransplant function are related to donor demographics and injury mechanisms.


OBJECTIVE
To examine factors influencing islets recovery and in vivo function with emphasis on donor-related factors.


METHODS
Islets were isolated from 99 human donor pancreata, and islet yield was reported as islet equivalent per gram pancreatic tissue. Donor, procurement, and isolation factors were collected for each isolation and correlation statistics were performed between these variables and islet yield.


RESULTS
Results indicated a differential effect of enzyme mixes on yield with Collagenase P digestion most suitable for increased ischemic time (R2 = 0.1; P < .08), Liberase with small donor pancreas size and elevated preprocurement glucose (R2 = 0.15; P < .02), and Serva with female donors (R2 = 0.17; P < .06). Islets from 29 isolations were further tested by transplantation under the kidney capsule of immune-deficient NOD-SCID mice. Although all 29 preparations had acceptable in vitro perfusion parameters indicating viability, only 19 functioned in vivo with serum levels of insulin >5 U/mL and C peptide >1.5 ng/mL. No significant differences in donor, procurement, and isolation factors were evident between the islet preparations that functioned in vivo and those that were nonfunctional.


CONCLUSIONS
These data demonstrate that although yield is affected by a variety of donor factors and enzyme mixes, these factors do not affect islet in vivo function.
Sabek
Omaima M
OM
University of Tennessee Health Science Centre, Memphis, USA.
Cowan
Patricia
P
Fraga
Daniel W
DW
Gaber
A Osama
AO
D000328:Adult; D000818:Animals; D002469:Cell Separation; D002470:Cell Survival; D017364:Collagenases; D005260:Female; D006801:Humans; D007515:Islets of Langerhans / Q000166:cytology* / Q000254:growth & development; D016381:Islets of Langerhans Transplantation; D008297:Male; D051379:Mice; D016688:Mice, Inbred NOD; D016513:Mice, SCID; D015999:Multivariate Analysis; D012044:Regression Analysis; D013820:Thermolysin; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*
D017364:Collagenases; C106635:Liberase; D013820:Thermolysin