International workshop: islet transplantation without borders enabling islet transplantation in Greece with international collaboration and innovative technology

Abstract

Recently, initiatives have been undertaken to establish an islet transplantation program in Athens, Greece. A major hurtle is the high cost associated with the establishment and maintenance of a clinical-grade islet manufacturing center. A collaboration was established with the University Hospitals of Geneva, Switzerland, to enable remote islet cell manufacturing with an established and validated fully operational team. However, remote islet manufacturing requires shipment of the pancreas from the procurement to the islet manufacturing site (in this case from anywhere in Greece to Geneva) and then shipment of the islets from the manufacturing site to the transplant site (from Geneva to Athens). To address challenges related to cold ischemia time of the pancreas and shipment time of islets, a collaboration was initiated with the University of Arizona, Tucson, USA. An international workshop was held in Athens, December 2011, to mark the start of this collaborative project. Experts in the field presented in three main sessions: [1] Islet transplantation: state-of-the-art, and the “network approach”; [2] Technical aspects of clinical islet transplantation and outcomes; and [3] Islet manufacturing – from the donated pancreas to the islet product. This manuscript presents a summary of the workshop.

Clinical islet isolation and transplantation outcomes with deceased cardiac death donors are similar to neurological determination of death donors

“…In Canada, the distances between centres are substantial, and the current study confirms that pancreata procured in distant hospitals should be considered for islet isolation and transplantation, irrespective of the donor type. This is especially relevant in islet transplantation where core islet isolation facilities often serve a larger catchment area for donor hospital procurement, including crossing of national borders on occasion [17][18][19][20]. In the current series, DCD represented <5% of all processed pancreata.…”

Mitigating hypoxic stress on pancreatic islets via in situ oxygen generating biomaterial

“…Inadequate oxygenation during in vitro culture and after in vivo intraportal transplantation has been recognized as a major factor contributing to decreased islet survival during culture and significant graft loss following implantation [33–35]. During the pre-transplant culture period, islets are exposed to detrimental oxygen gradients that can result in significant declines in viability and function [36].…”

Human Islet Viability and Function Is Maintained During High-density Shipment in Silicone Rubber Membrane Vessels

“…Having the capacity to effectively transport human islets for clinical and research purposes is an important consideration for clinical islet transplantation [5] and in the field of diabetes research. It will allow for hospitals which do not have the capabilities of maintaining an islet manufacturing center to receive high quality products.…”

“…However, the expense of establishing and maintaining large numbers of islet manufacturing centers is prohibitive [5]. In order to reduce transplant recipient burden and promote research at distant establishments, it is essential to be able to ship islets in a simple, cost-effective manner while maintaining cell viability and function upon receipt [6].…”