No beneficial effect of two-layer storage compared with UW-storage on human islet isolation and transplantation.
BACKGROUND
Shipment of pancreata between distant centers is frequently associated with prolonged cold ischemia time (CIT) that leads to poorer outcomes for islet transplantation. Clinical pilot trials have indicated that oxygenation of explanted human pancreata utilizing the two-layer method (TLM) allows the use of marginal donor pancreata for islet transplantation. The present study aimed to clarify whether TLM enhances the ischemic tolerance of human pancreata.


METHODS
We analyzed retrospectively the outcome of 200 human islet isolations performed after TLM preservation or storage in University of Wisconsin solution (UWS).


RESULTS
Donor characteristics and digestion parameters did not vary significantly between TLM-preserved and UWS-stored pancreata. No differences were observed between experimental groups with regard to islet yield, purity, or dynamic glucose stimulation index after either short or prolonged CIT. However, CIT and stimulation index were negatively correlated in each experimental group. The isolation outcome in donors aged > or =60 years was not increased after TLM preservation when compared to UWS storage. No effect was observed regarding islet posttransplant function in recipients with established kidney grafts.


CONCLUSIONS
The present study suggests that the ischemic tolerance of human pancreata cannot be extended by TLM preservation. In addition, TLM does not seem to improve the isolation outcome for pancreata from elderly donors.
Caballero-Corbalán
José
J
Department of Oncology, Radiology & Clinical Immunology, Division of Clinical Immunology, Uppsala University Hospital, Uppsala, Sweden.
Eich
Torsten
T
Lundgren
Torbjörn
T
Foss
Aksel
A
Felldin
Marie
M
Källen
Ragnar
R
Salmela
Kalja
K
Tibell
Annika
A
Tufveson
Gunnar
G
Korsgren
Olle
O
Brandhorst
Daniel
D
D000241:Adenosine / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000494:pharmacology; D005260:Female; D005978:Glutathione / Q000494:pharmacology; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D007515:Islets of Langerhans / Q000378:metabolism; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000295:instrumentation* / Q000379:methods; D019188:Organ Preservation Solutions / Q000494:pharmacology; D010179:Pancreas / Q000378:metabolism; D010865:Pilot Projects; D011887:Raffinose / Q000494:pharmacology; D012189:Retrospective Studies; D013048:Specimen Handling; D013997:Time Factors; D016896:Treatment Outcome
D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose