Toward maximizing the success rates of human islet isolation: influence of donor and isolation factors.
In order to make islet transplantation a therapeutic option for patients with diabetes there is an urgent need for more efficient islet cell processing to maximize islet recovery. Improved donor management, organ recovery techniques, implementation of more stringent donor criteria, and improved islet cell processing techniques may contribute to enhance organ utilization for transplantation. We have analyzed the effects of donor and islet processing factors on the success rate of human islet cell processing for transplantation performed at a single islet cell processing center. Islet isolation outcomes improved when vasopressors, and in particular pitressin, and steroids were used for the management of multiorgan donors. Higher islet yields were obtained from adult male donors, BMI >25 kg/m2, adequate glycemic control during hospital stay, and when the pancreas was retrieved by a local surgical team. Successful isolations were obtained in 58% of the cases when > or = 4 donor criteria were met, and even higher success rates (69%) were observed when considering > or = 5 criteria. Our data suggest that a sequential, integrated approach is highly desirable to improve the success rate of islet cell processing.
Ponte
Gaston M
GM
Cell Transplant Center and Clinical Islet Transplant Center, Diabetes Research Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA.
Pileggi
Antonello
A
Messinger
Shari
S
Alejandro
Angel
A
Ichii
Hirohito
H
Baidal
David A
DA
Khan
Aisha
A
Ricordi
Camillo
C
Goss
John A
JA
Alejandro
Rodolfo
R
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002102:Cadaver; D002469:Cell Separation / Q000592:standards; D046148:Donor Selection; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000166:cytology* / Q000378:metabolism; D016381:Islets of Langerhans Transplantation; D008297:Male; D009752:Nutritional Status; D010179:Pancreas / Q000166:cytology* / Q000378:metabolism / Q000502:physiology; D015203:Reproducibility of Results; D014019:Tissue Donors / Q000706:statistics & numerical data*; D020858:Tissue and Organ Harvesting / Q000379:methods / Q000592:standards*; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome
D007328:Insulin