title: Islet of Langerhans isolation from pediatric and juvenile donor pancreases.
abstract: Islet grafts isolated from young donors allow superior functional outcomes but are often associated with poor islet isolation yields. The objective of this study was to comparatively analyze the outcomes of islet isolation between young and older donors. We retrospectively analyzed 564 pancreas isolations performed at our institution. Isolation outcomes were compared between donors aged ≤20 years (n = 42, YD) and >20 years (n = 522, OD). Isolation procedure was identical in both groups. Prepurification percentage of embedded islets was higher in YD (44.3 ± 22.7% vs. 24.9 ± 20.9%, P < 0.001). This led to a lower recovery rate in YD (48% vs. 76%, P = 0.002) and hence lower postpurification IEQ/g pancreas in YD (2 412 ± 1 789 IEQ/g vs. 3 194 ± 1 892 IEQ/g, P = 0.01). Final yield was 180 982 ± 128 073 IEQ in YD and 244 167 ± 134 137 IEQ in OD, (P = 0.006). In vitro function was markedly, albeit nonsignificantly, higher in YD (SI: 4.5 ± 5.1 vs. 3.0 ± 5.7, P = 0.350). Proportion of transplanted preparations was similar in both groups, 38% (16/42) in YD vs. 43% (224/522) in OD, P = 0.628. In spite of isolation and purification difficulties, pancreases from young donors allowed similar islet transplantation rates as older donors. Efforts should be directed at improving islet extraction in these donors to realize their full potential for islet transplantation.
authors.affiliation: Department of Surgery, Cell Isolation and Transplantation Center, University of Geneva Hospitals and School of Medicine, Geneva, Switzerland.
authors.forename: Raphael P H
authors.initials: RP
authors.lastname: Meier
authors.forename: Ismail
authors.initials: I
authors.lastname: Sert
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Yannick D
authors.initials: YD
authors.lastname: Muller
authors.forename: Sophie
authors.initials: S
authors.lastname: Borot
authors.forename: Lionel
authors.initials: L
authors.lastname: Badet
authors.forename: Christian
authors.initials: C
authors.lastname: Toso
authors.forename: Domenico
authors.initials: D
authors.lastname: Bosco
authors.forename: Thierry
authors.initials: T
authors.lastname: Berney
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002423:Cause of Death; D002452:Cell Count; D002469:Cell Separation / Q000295:instrumentation / Q000379:methods*; D002648:Child; D050377:Cold Ischemia; D017364:Collagenases; D005362:Ficoll; D006085:Graft Survival; D006801:Humans; D007515:Islets of Langerhans / Q000166:cytology*; D016381:Islets of Langerhans Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D010179:Pancreas / Q000166:cytology*; D012189:Retrospective Studies; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005362:Ficoll; D017364:Collagenases
keywords: islet isolation; islet transplantation; type 1 diabetes mellitus; young donors