A Meta-Analysis for Comparison of the Two-Layer and University of Wisconsin Pancreas Preservation Methods in Islet Transplantation

Qin, Haili; Matsumoto, Shinichi; Klintmalm, Göran B.; Vol, Edward B. De

doi:10.3727/096368910x544942

Cited by 30 publications

(20 citation statements)

References 26 publications

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“…Most isolation procedures involve the use of the UW (University of Wisconsin) solution, which contains electrolytes and other substances that contribute to cell integrity (30). However, some studies have found that the combined use of UW solution and other substances with high oxygen affinity (two-layer perfluorocarbon method) led to improved pancreatic preservation (54,55), although these results were most pronounced in cases of prolonged cold ischemia (56).…”

Section: Islet Transplantation and The Current Status Of This Procedumentioning

confidence: 99%

Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory

Rheinheimer

Bauer

Silveiro

et al. 2015

Arch. Endocrinol. Metab.

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Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with "brittle T1DM" , who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and hypoglycemic perception. The Edmonton group demonstrated that most patients who received islet infusions from more than one donor and were treated with steroid-free immunosuppressive drugs displayed a considerable decline in the initial insulin independence rates at eight years following the transplantation, but showed permanent C-peptide secretion, which facilitated glycemic control and protected patients against hypoglycemic episodes. Recently, data published by the Collaborative Islet Transplant Registry (CITR) has revealed that approximately 50% of the patients who undergo islet transplantation are insulin independent after a 3-year follow-up. Therefore, islet transplantation is able to successfully decrease plasma glucose and HbA1c levels, the occurrence of severe hypoglycemia, and improve patient quality of life. The goal of this paper was to review the human islet isolation and transplantation processes, and to describe the establishment of a human islet isolation laboratory at the Endocrine Division of the Hospital de Clínicas de Porto Alegre -Rio Grande do Sul, Brazil. Arch Endocrinol Metab. 2015;59(2):161-70

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Section: Islet Transplantation and The Current Status Of This Procedumentioning

confidence: 99%

Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory

Rheinheimer

Bauer

Silveiro

et al. 2015

Arch. Endocrinol. Metab.

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“…The heterogeneity that we observed could originate from the improvement of islet isolation over the years, as well as differences in donor selection, enzyme batches, isolation procedures, culture medium and other reagents used for promoting islet survival. Besides that, it could also raise from differences in expertise of the isolation teams, 28,33,[39][40][41][42] and from the fact that techniques used for evaluation of SI and viability can be slightly different between studies. Regarding insulin secretion, studies used different glucose incubation time and different high and low glucose concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the high values found for the variable IEQ/g pancreas, the results for this outcome are summarized as median of the SMD calculated by the Hedges method. 42,45 For viability, purity and SI, the results are shown as median of the unstandardized WMD. For all outcomes, 95% credible intervals (CrIs, the Bayesian equivalents of CI) are also shown.…”

Section: Statistical Analysesmentioning

confidence: 99%

Different digestion enzymes used for human pancreatic islet isolation: A mixed treatment comparison (MTC) meta-analysis

Rheinheimer

Ziegelmann

Carlessi

et al. 2014

Islets

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Daisy Crispim (2014) Different digestion enzymes used for human pancreatic islet isolation: A mixed treatment comparison (MTC) meta-analysis, Islets, 6:4, e977118, DOI: 10.4161/19382014.2014.977118 To link to this article: https://doi.org/10. 4161/19382014.2014 Collagenases are critical reagents determining yield and quality of isolated human pancreatic islets and may affect islet transplantation outcome. Some islet transplantation centers have compared 2 or more collagenase blends; however, the results regarding differences in quantity and quality of islets are conflicting. Thus, for the first time, a mixed treatment comparison (MTC) meta-analysis was carried out to compile data about the effect of different collagenases used for human pancreas digestion on islet yield, purity, viability and stimulation index (SI). Pubmed, Embase and Cochrane libraries were searched. Of 755 articles retrieved, a total of 15 articles fulfilled the eligibility criteria and were included in the MTC meta-analysis. Our results revealed that Vitacyte and Liberase MTF were associated with a small increase in islet yield (islet equivalent number/g pancreas) when compared with Sevac enzyme [standardized mean difference (95% credible interval -CrI) D ¡2.19 (¡4.25 to ¡0.21) and ¡2.28 (¡4.49 to ¡0.23), respectively]. However, all other enzyme comparisons did not show any significant difference regarding islet yield. Purity and viability percentages were not significantly different among any of the analyzed digestion enzymes. Interestingly, Vitacyte and Serva NB1 were associated with increased SI when compared with Liberase MTF enzyme [unstandardized weighted mean difference (95% CrI) D ¡1.69 (¡2.87 to ¡0.51) and ¡1.07 (¡1.79 to ¡0.39), respectively]. In conclusion, our MTC meta-analysis suggests that the digestion enzymes currently being used for islet isolation works with similar efficiency regarding islet yield, purity and viability; however, Vitacyte and Serva NB1 enzymes seem to be associated with an improved SI as compared with Liberase MTF.

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“…27 After completion of PDP, the pancreas was preserved with the two-layer method using the corresponding preservation solutions of ETKS or CSPS and perfluorocarbon. 28 , 29 No PDP was performed for the control group, but the recovered pancreas was preserved with the two-layer method with CSPS and perfluorocarbon ( n = 6).…”

Section: Methodsmentioning

confidence: 99%

Pancreatic Ductal Perfusion at Organ Procurement Enhances Islet Yield in Human Islet Isolation

Takita¹,

Itoh²,

Shimoda³

et al. 2014

Pancreas

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Objective Pancreas preservation is a major factor influencing the results of islet cell transplantation. This study evaluated the effects of two different solutions for pancreatic ductal perfusion (PDP) at organ procurement. Methods Eighteen human pancreases were assigned to three groups: non-PDP (control), PDP with ET-Kyoto solution, and PDP with cold storage/purification stock solution. Pancreatic islets were isolated according to the modified Ricordi method. Results No significant differences in donor characteristics, including cold ischemia time, were observed between the three groups. All islet isolations in the PDP groups had >400,000 IEQ in total islet yield post-purification, a significant increase when compared with the control (P = 0.04 and <0.01). The islet quality assessments—including an in vivo diabetic nude mice assay and the response of high-mobility group box protein 1 to cytokine stimulation—also showed no significant differences. The proportion of TUNEL-positive cells showing apoptosis in islets in the PDP groups was significantly lower than in the control group (P < 0.05). Conclusion Both ET-Kyoto solution and cold storage/purification stock solution are suitable for PDP and consistently resulted in isolation success. Further studies with a larger number of pancreas donors should be done to compare the effects of the PDP solutions.

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A Meta-Analysis for Comparison of the Two-Layer and University of Wisconsin Pancreas Preservation Methods in Islet Transplantation

Cited by 30 publications

References 26 publications

Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory

Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory

Different digestion enzymes used for human pancreatic islet isolation: A mixed treatment comparison (MTC) meta-analysis

Pancreatic Ductal Perfusion at Organ Procurement Enhances Islet Yield in Human Islet Isolation

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