Influence of preservation solution on human islet isolation outcome.
BACKGROUND
The influence of the preservation solution used for in situ perfusion of the donor and pancreas storage on islet isolation has received little attention.


METHODS
In this prospective controlled trial, we compared the outcome of human islet isolation from pancreata perfused with University of Wisconsin (UW) solution or Celsior, an alternative colloid-free extracellular solution.


RESULTS
At the 1-year interim analysis, the viability and insulin secretion of islets isolated from donors perfused with UW (n=19) or Celsior (n=5) were identical. However, total islet recovery (IEQ) and isolation yield (IEQ/g) were 1.8-fold and 2.1-fold inferior in the Celsior group (P<0.05 vs. UW). Overall, 13 (68%) of islet preparations were effectively transplanted from the UW group vs. none from the Celsior group (P=0.01). The clinical study was discontinued and the causes of these differences were further explored in the pig (n=14). In contrast to UW, Celsior induced cell swelling and pancreas edema after only four hours of cold storage. These abnormalities were delayed when the donor was perfused with Solution de Conservation d'Organes et de Tissus (SCOT), an extracellular solution containing polyethylene glycol.


CONCLUSIONS
Our results suggest that colloid-free preservation solutions might be suboptimal for pancreas perfusion and cold storage prior to islet isolation and transplantation. Because pancreata are now frequently recovered for islet transplantation, preliminary experimental and clinical data about islet isolation should be obtained prior to the routine implementation of new preservation solutions for abdominal perfusion during multiorgan recovery.
Hubert
Thomas
T
Inserm U859, Diabetes Cell Therapy, Faculty of Medicine, Lille 2 University, Lille, France.
Gmyr
Valéry
V
Arnalsteen
Laurent
L
Jany
Thomas
T
Triponez
Frédéric
F
Caiazzo
Robert
R
Vandewalle
Brigitte
B
Vantyghem
Marie-Christine
MC
Kerr-Conte
Julie
J
Pattou
Francois
F
D000241:Adenosine / Q000494:pharmacology; D000293:Adolescent; D000328:Adult; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D016022:Case-Control Studies; D003102:Colloids / Q000032:analysis; D004187:Disaccharides / Q000494:pharmacology; D004573:Electrolytes / Q000494:pharmacology; D005971:Glutamates / Q000494:pharmacology; D005978:Glutathione / Q000494:pharmacology; D006639:Histidine / Q000494:pharmacology; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D007515:Islets of Langerhans / Q000166:cytology / Q000187:drug effects* / Q000502:physiology; D016381:Islets of Langerhans Transplantation; D019520:Living Donors; D008353:Mannitol / Q000494:pharmacology; D008875:Middle Aged; D019188:Organ Preservation Solutions / Q000737:chemistry* / Q000494:pharmacology*; D011446:Prospective Studies; D011887:Raffinose / Q000494:pharmacology; D016896:Treatment Outcome
C088453:Celsior; D003102:Colloids; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D006639:Histidine; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose