title: Extracorporeal machine perfusion of the pancreas: technical aspects and its clinical implications--a systematic review of experimental models.
abstract: Pancreas or pancreatic islet transplantation is an important treatment option for insulin-dependent diabetes and its complications. However, as the pancreas is particularly susceptible to ischaemic-reperfusion injury, the criteria for pancreas and islet donation are especially strict. With a chronic shortage of donors, one critical challenge is to maximise organ availability and expand the donor pool. To achieve that, continuous improvement in organ preservation is required, with the aims of reducing ischaemia-reperfusion injury, prolong preservation time and improve graft function. Static cold storage, the only method used in clinical pancreas and islet cell transplant currently, has likely reached its plateau. Machine perfusion, hypothermic or normothermic, could hold the key to improving donor pancreas quality as well as quantity available for transplant. This article reviews the literature on experimental models of pancreas machine perfusion, examines the benefits of machine perfusion, the technical aspects and their clinical implications.
authors.affiliation: Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.
authors.forename: Kean Guan
authors.initials: KG
authors.lastname: Kuan
authors.affiliation: Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.
authors.forename: Mau Nam
authors.initials: MN
authors.lastname: Wee
authors.affiliation: Department of Hepatobiliary Surgery, Leicester General Hospital, Leicester, United Kingdom.
authors.forename: Wen Yuan
authors.initials: WY
authors.lastname: Chung
authors.affiliation: Department of Hepatobiliary Surgery, Leicester General Hospital, Leicester, United Kingdom.
authors.forename: Rohan
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.
authors.forename: Soeren Torge
authors.initials: ST
authors.lastname: Mees
authors.affiliation: Department of Hepatobiliary Surgery, Leicester General Hospital, Leicester, United Kingdom.
authors.forename: Ashley
authors.initials: A
authors.lastname: Dennison
authors.affiliation: Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.
authors.forename: Guy
authors.initials: G
authors.lastname: Maddern
authors.affiliation: Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia, Australia. Electronic address: markus.trochsler@health.sa.gov.au.
authors.forename: Markus
authors.initials: M
authors.lastname: Trochsler
mesh_terms: D005112:Extracorporeal Circulation; D006801:Humans; D016381:Islets of Langerhans Transplantation; D009926:Organ Preservation