Pancreas and Islet Transplantation: Pancreas and Islet Transplantation in Diabetes Mellitus

Johnson, Paul; Sharples, Edward; Sinha, Sanjay; Friend, Peter J.

doi:10.1007/978-3-030-55244-2_13

Cited by 4 publications

(7 citation statements)

References 37 publications

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“…NOTE: This is done in the housing facility. 4. Transfer the animal from the housing facility to the operating room (OR), where recovery of the organ will be performed.…”

Section: Organ Procurementmentioning

confidence: 99%

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Normothermic <em>Ex Vivo</em> Pancreas Perfusion for the Preservation of Pancreas Allografts before Transplantation

Parmentier

Ray

Mazilescu

et al. 2022

JoVE

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Pancreas transplantation (PTx) is a curative treatment for people who live with the burden of a diagnosis of diabetes mellitus (DM). However, due to organ shortages and increasing numbers of patients being listed for PTx, new strategies are needed to increase the number of available grafts for transplantation.Static cold storage (SCS) is considered the gold standard for standard criteria organs.However, standard criteria donors (SCD) are becoming scarce and new strategies that can increase the rate of organ acceptance from extended criteria donors (ECD) are urgently needed.Normothermic ex vivo perfusion (NEVP) is one of the strategies that has become increasingly popular over the past couple of decades. This preservation method has already been used successfully in other organs (liver, kidneys, and lungs) but has been minimally explored in pancreas transplantation. The few papers that describe the method for pancreas show little success, edema being one of the major issues. The following manuscript describes the successful NEVP method and setup developed by our group to perfuse swine pancreas.

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“…NOTE: This is done in the housing facility. 4. Transfer the animal from the housing facility to the operating room (OR), where recovery of the organ will be performed.…”

Section: Organ Procurementmentioning

confidence: 99%

“…The pancreas is the most often discarded organ after retrieval from deceased donors 4 . With ongoing organ shortages and 1.…”

Section: Introductionmentioning

confidence: 99%

Normothermic <em>Ex Vivo</em> Pancreas Perfusion for the Preservation of Pancreas Allografts before Transplantation

Parmentier

Ray

Mazilescu

et al. 2022

JoVE

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“…Even with an increasing need for pancreas grafts, donor selection continues to be very restrictive, and the conversion rate from donation to transplant remains low [ 9 ]. In addition, the pancreas continues to be the most discarded organ.…”

Section: Introductionmentioning

confidence: 99%

“…In Canada, in 2019, out of a total of 820 deceased donors, only 68 pancreases were transplanted [ 10 ]. In the UK, only 1/3 of accepted pancreases are transplanted [ 9 , 11 ]. Not surprisingly, the number of PTx performed is considerably lower as compared to kidney, liver, heart, and lung [ 9 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the UK, only 1/3 of accepted pancreases are transplanted [ 9 , 11 ]. Not surprisingly, the number of PTx performed is considerably lower as compared to kidney, liver, heart, and lung [ 9 , 12 ]. Strategies that will allow for the assessment and repair of pancreas allografts have the potential to reverse this trend in pancreas donation.…”

Section: Introductionmentioning

confidence: 99%

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Normothermic Ex Vivo Machine Perfusion of Discarded Human Pancreas Allografts: A Feasibility Study

et al. 2023

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Pancreas transplantation is the only curative treatment for patients with complicated diabetes, and organ shortage is a common and increasing problem. Strategies to expand the donor pool are needed, and normothermic ex vivo perfusion of the pancreas has the potential to test and repair grafts before implantation. Between January 2021 and April 2022, six human pancreases, declined for transplantation or islet isolation, were perfused using a previously established method by our group. All 6 cases were successfully perfused for 4 h, with minimal edema. The mean age of the donors was 44.16 ± 13.8 years. Five grafts were obtained from neurological death donors, and one was obtained from a donation after cardiac death. The mean glucose and lactate levels decreased throughout perfusion and insulin levels increased. All 6 grafts were metabolically active during perfusion and histopathology showed minimal tissue injury and no edema. Human normothermic ex vivo perfusion of the pancreas is feasible and safe and has the potential to expand the donor pool. Future studies will focus on tests and biomarkers for the assessment of grafts.

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Whole-Organ Pancreas and Islets Transplantations in UK: An Overview and Future Directions

Martín

Alberti

Demartines

et al. 2023

JCM

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Whole-organ pancreas and islets transplantations are two therapeutic options to treat type 1 diabetic patients resistant to optimised medical treatment in whom severe complications develop. Selection of the best option for β-cell replacement depends on several factors such as kidney function, patient comorbidities, and treatment goals. For a patient with end-stage kidney disease, the treatment of choice is often a simultaneous transplant of the pancreas and kidney (SPK). However, it remains a major surgical procedure in patients with multiple comorbidities and therefore it is important to select those who will benefit from it. Additionally, in view of the organ shortage, new strategies to improve outcomes and reduce immune reactions have been developed, including dynamic organ perfusion technologies, pancreas bioengineering, and stem cell therapies. The purpose of this article is to review the indications, surgical techniques, outcomes, and future directions of whole-organ pancreas and islets transplantations.

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Pancreas and Islet Transplantation: Pancreas and Islet Transplantation in Diabetes Mellitus

Cited by 4 publications

References 37 publications

Normothermic <em>Ex Vivo</em> Pancreas Perfusion for the Preservation of Pancreas Allografts before Transplantation

Normothermic <em>Ex Vivo</em> Pancreas Perfusion for the Preservation of Pancreas Allografts before Transplantation

Normothermic Ex Vivo Machine Perfusion of Discarded Human Pancreas Allografts: A Feasibility Study

Whole-Organ Pancreas and Islets Transplantations in UK: An Overview and Future Directions

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