title: A meta-analysis for comparison of the two-layer and university of Wisconsin pancreas preservation methods in islet transplantation.
abstract: Conflicting results have been reported on the effectiveness of the two-layer method (TLM) compared with the University of Wisconsin (UW) method for preserving pancreata. The objective of this study was to compile the evidence for or against any difference in human islet yield and viability  between these two. PubMed (January 2000 to May 2008) and Cochran Library searches were performed and 17 studies were included for the meta-analysis. Data on donor characteristics, preservation time, and outcomes were abstracted. Studies were subgrouped based on how TLM was used (UW + TLM or  TLM alone), on mean cold ischemic time (CIT) (>20 h or <20 h), and on whether special chemical was used (yes or no). Meta-analysis of all studies and subgroups was performed and the pooled standardized mean differences (SMD) with 95% confidence intervals (CI) were reported. Overall,  the use of TLM significantly increased islet yield [SMD, 0.74 (0.44-1.04)] and viability [SMD, 0.63 (0.14-1.12)]. The beneficial effects of TLM on islet yield were more evident when TLM was used following UW storage or when prolonged CIT was used. TLM used alone, shorter CIT,  and no chemical use all resulted in similar islet viability between TLM and UW groups. Beneficial effects of TLM on islet viability were demonstrated only when TLM was used following UW storage, or with prolonged CIT, or with chemical use. In conclusion, the TLM was beneficial for prolonged  pancreas preservation before human islet isolation; however, benefit of the TLM for short-term preservation was not clear.
authors.affiliation: Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, TX 75206, USA. HuanyinQ@BaylorHealth.edu
authors.forename: Huanying
authors.initials: H
authors.lastname: Qin
authors.forename: Shinichi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Goran B
authors.initials: GB
authors.lastname: Klintmalm
authors.forename: Edward B
authors.initials: EB
authors.lastname: De Vol
mesh_terms: D000241:Adenosine / Q000494:pharmacology; D000493:Allopurinol / Q000494:pharmacology; D002470:Cell Survival; D005978:Glutathione / Q000494:pharmacology; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D007515:Islets of Langerhans / Q000166:cytology; D016381:Islets of Langerhans Transplantation; D009926:Organ Preservation; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D010179:Pancreas / Q000187:drug effects*; D039781:PubMed; D011887:Raffinose / Q000494:pharmacology; D013997:Time Factors
chemical_list: D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose