Testing combinations of protease inhibitor and preservation solution to improve islet quality and yield.
Pancreas preservation using an oxygenated two-layer method (TLM) has been reported to improve islet yields, as has supplementation of Liberase with Pefabloc. We hypothesized that using both TLM and Pefabloc could enhance islet yield as compared with preservation in University of Wisconsin (UW) or Histidine-Tryptophan Ketoglutarate (HTK) solution.


METHODS
Ninety-eight pancreata with no significant differences of age, body mass index, or cold ischemia time preserved randomly with UW (n = 40), TLM (n = 48), or HTK (n = 10) were processed with (n = 36) or without (n = 66) Pefabloc.


RESULTS
The total islet equivalent (IEQ) from TLM-preserved pancreata processed with Pefabloc (n = 12) showed lower yields versus those processed without Pefabloc (n = 36): 216,120 +/- 27,906 vs. 301,427 +/- 21,447 IEQ (P < .05). Islets from 1 of 12 (8.33%) pancreata processed with Pefabloc in TLM were transplanted, in contrast with 15/36 TLM (41.67%) pancreata processed without it. Islet yields were not significantly different among pancreata preserved in UW and processed with Pefabloc (n = 17) versus without Pefabloc (n = 23): 342,693 +/- 45,588 versus 266,609 +/- 29,006 IEQ (P = .149). The number of transplants from UW-preserved pancreata was 3/17 (17.65%) when processed with Pefabloc and 4/23 (17.39%) without. Among the HTK group, there was no significant difference in islet yields between pancreata processed with (n = 7) versus without Pefabloc (n = 3): 248,227 +/- 65,294 versus 483,555 +/- 144,070 IEQ (P = .118).


CONCLUSIONS
Pefabloc showed no benefit to improve islet yields. Pancreata preserved in TLM provided better transplant quality islets when processed in the absence of Pefabloc.
Al-Abdullah
I H
IH
City of Hope National Medical Center and Beckman Research Institute, Duarte, California 91010, USA. Ial-abdullah@coh.org
Bentsi-Barnes
K
K
Valiente
L
L
Omori
K
K
Iglesias
I
I
Orr
C
C
Umeadi
C
C
Ferreri
K
K
Todorov
I
I
Al-Sayed
M
M
Kandeel
F
F
D000241:Adenosine; D000493:Allopurinol; D002102:Cadaver; D002452:Cell Count; D005260:Female; D005947:Glucose; D005978:Glutathione; D006801:Humans; D007328:Insulin; D007515:Islets of Langerhans / Q000166:cytology* / Q000187:drug effects / Q000502:physiology; D008297:Male; D008353:Mannitol; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions; D009929:Organ Size; D010101:Oxygen Consumption; D010179:Pancreas; D011189:Potassium Chloride; D011343:Procaine; D011480:Protease Inhibitors / Q000627:therapeutic use*; D011887:Raffinose; D014019:Tissue Donors
C039984:Bretschneider cardioplegic solution; D007328:Insulin; D019188:Organ Preservation Solutions; D011480:Protease Inhibitors; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose