Pancreas preservation for pancreas and islet transplantation
- 1 August 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Organ Transplantation
- Vol. 13 (4), 445-451
- https://doi.org/10.1097/mot.0b013e328303df04
Abstract
Purpose of review To summarize advances and limitations in pancreas procurement and preservation for pancreas and islet transplantation, and review advances in islet protection and preservation. Recent findings Pancreases procured after cardiac death, with in-situ regional organ cooling, have been successfully used for islet transplantation. Colloid-free Celsior and histidine-tryptophan-ketoglutarate preservation solutions are comparable to University of Wisconsin solution when used for cold storage before pancreas transplantation. Colloid-free preservation solutions are inferior to University of Wisconsin solution for pancreas preservation prior to islet isolation and transplantation. Clinical reports on pancreas and islet transplants suggest that the two-layer method may not offer significant benefits over cold storage with the University of Wisconsin solution: improved oxygenation may depend on the graft size; benefits in experimental models may not translate to human organs. Improvements in islet yield and quality occurred from pancreases treated with inhibitors of stress-induced apoptosis during procurement, storage, isolation or culture. Pancreas perfusion may be desirable before islet isolation and transplantation and may improve islet yields and quality. Methods for real-time, noninvasive assessment of pancreas quality during preservation have been implemented and objective islet potency assays have been developed and validated. These innovations should contribute to objective evaluation and establishment of improved pancreas preservation and islet isolation strategies. Summary Cold storage may be adequate for preservation before pancreas transplants, but insufficient when pancreases are processed for islets or when expanded donors are used. Supplementation of cold storage solutions with cytoprotective agents and perfusion may improve pancreas and islet transplant outcomes.Keywords
This publication has 81 references indexed in Scilit:
- Real-Time Noninvasive Assessment of Pancreatic ATP Levels During Cold PreservationTransplantation Proceedings, 2008
- Twenty-Four Hour Hypothermic Machine Perfusion Preservation of Porcine Pancreas Facilitates Processing for Islet IsolationTransplantation Proceedings, 2008
- Application of the Two-Layer Method on Pancreas Digestion Results in Improved Islet Yield and Maintained Viability of Isolated IsletsTransplantation, 2007
- Human Islet Oxygen Consumption Rate and DNA Measurements Predict Diabetes Reversal in Nude MiceAmerican Journal of Transplantation, 2007
- Islet Isolation and Transplantation Outcomes of Pancreas Preserved with University of Wisconsin Solution Versus Two-Layer Method Using Preoxygenated PerfluorocarbonTransplantation, 2006
- Successful Islet Transplantation from Nonheartbeating Donor Pancreata Using Modified Ricordi Islet Isolation MethodTransplantation, 2006
- Improved islet yield and function with ductal injection of University of Wisconsin solution before pancreas preservation1Transplantation, 2003
- Impact of two-layer pancreas preservation on islet isolation and transplantation1Transplantation, 2002
- Preservation of the human pancreas before islet isolation using a two-layer (UW solution???perfluorochemical) cold storage method1Transplantation, 2002
- Twenty-Four-Hour Preservation of the Duct-Ligated Canine Pancreatic AllograftEuropean Surgical Research, 1975