title: Islet versus pancreas transplantation in Brazil: Defining criteria for pancreas allocation decision.
abstract: BACKGROUND
  Many studies have evaluated whether there are characteristics related to pancreas donors and the islet isolation process that can influence pancreatic islet yield. However, this analysis has not yet been performed in Brazil, one of the world leaders in whole pancreas organ transplantation (WOPT), where pancreas allocation for pancreatic islet transplantation (PIT) has no officially defined criteria. Definition of parameters that would predict the outcome of islet isolation from local pancreas donors would be useful for defining allocation priority in Brazil.
  
  
  OBJECTIVE
  To analyze the relationship between multiple donor-related and islet isolation variables with the total number of isolated pancreatic islet equivalents (IEQ) in a brazilian sample of pancreas donors.
  
  
  METHODS
  Several variables were analyzed in 74 pancreata relative to the outcome of total IEQs obtained at the end of the process.
  
  
  RESULTS
  In univariate analysis, body mass index (BMI) (p = 0.003), the presence of fatty infiltrates in the pancreas as observed during harvesting (p = 0.042) and pancreas digestion time (p = 0.046) were identified as variables related to a greater IEQ yield. In a multivariate analysis a statistically significant contribution to the variability of islet yield was found only for the BMI (p = 0.017). A ROC curve defined a BMI = 30 as a cut-off point, with pancreata from donors with BMI > 30 yielding more islets than donors with BMI < 30 (p< 0.001).
  
  
  CONCLUSIONS
  These data reinforce the importance of the donor BMI as a defining parameter for successful islet isolation and establishes this variable as a potential pancreas allocation criterion in Brazil, where there is unequal competition for good quality organs between WOPT and PIT.
authors: Gastrosurgery Division, Department of Surgery, Federal University of São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil.
authors: Gustavo P D
authors: GP
authors: Sá
authors: Mari C
authors: MC
authors: Sogayar
authors: Freddy G
authors: FG
authors: Eliaschewitz
authors: Tércio
authors: T
authors: Genzini
authors: Renato
authors: R
authors: Letrinta
authors: Elton S
authors: ES
authors: Onari
authors: Marluce
authors: M
authors: Mantovani
authors: Leticia
authors: L
authors: Labriola
authors: Delcio
authors: D
authors: Matos
authors: Gaspar J
authors: GJ
authors: Lopes-Filho
authors: Adriano M
authors: AM
authors: Gonzalez
authors: Thiago R
authors: TR
authors: Mares-Guia
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001938:Brazil; D005260:Female; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D009927:Tissue and Organ Procurement / Q000379:methods*