title: Presence of hyperemic islets in human donor-pancreata results in reduced islet isolation yield.
abstract: When studying histological characteristics of human donor-pancreata, a remarkably high number of hyperemic islets (HIs) were encountered. The abnormalities in these HIs ranged from single/multiple dilated vessels to hemorrhages extending into the exocrine tissue. We aimed to determine the relevance of the presence of HIs in human donor-pancreata for isolation outcome and to identify donor and procurement factors associated with the occurrence of HIs. The presence of HIs was scored semi-quantitatively (HI-, HI+) in 102 human donor-pancreata. Islet isolation was performed in 40 cases. Donor and procurement factors were retrospectively analyzed in 94 donors. HIs were found in 54.6% of all donor-pancreata. However, only 4.5% of all islets in the affected pancreata was hyperemic. The affected pancreata contained slightly more endocrine tissue, but produced significantly lower yields. When corrected for other factors known to influence isolation outcome, the presence of HIs and endocrine content were the only factors significantly influencing isolation outcome. Prolonged ICU stay and pre-procurement hypertension were associated with the presence of HIs. This study is a first indication that the presence of HIs in human donor-pancreata are associated with reduced isolation outcomes and suggest an impact of the procurement procedure and pre-procurement hemodynamic status of the donor on the islet quality. It is tempting to speculate that this contributes to the generally experienced difficulties in obtaining sufficient amounts of human islets.
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands. d.e.hilling@lumc.nl
authors.forename: D E
authors.initials: DE
authors.lastname: Hilling
authors.forename: H A M
authors.initials: HA
authors.lastname: Töns
authors.forename: P J
authors.initials: PJ
authors.lastname: Marang-van de Mheen
authors.forename: A G
authors.initials: AG
authors.lastname: Baranski
authors.forename: E K
authors.initials: EK
authors.lastname: van den Akker
authors.forename: O T
authors.initials: OT
authors.lastname: Terpstra
authors.forename: E
authors.initials: E
authors.lastname: Bouwman
mesh_terms: D000328:Adult; D002469:Cell Separation; D005260:Female; D006801:Humans; D007515:Islets of Langerhans / Q000033:anatomy & histology / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000033:anatomy & histology / Q000098:blood supply*; D012039:Regional Blood Flow; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement