Pancreas Preservation by the Two-Layer Method: Does it Have a Beneficial Effect Compared with Simple Preservation in University of Wisconsin Solution?

Abstract

A large number of reports have shown that the two-layer method (TLM), which employs oxygenated perfluorochemical (PFC) and University of Wisconsin (UW) solution, is superior to simple cold storage in UW in islet transplantation. However, two recent large-scale studies showed no beneficial effect of TLM compared with UW storage in human islet transplantation. We reevaluated the effect of TLM by following three groups: group 1: UW simple storage; group 2: TLM performed by multiorgan procurement teams (not specialists of islet isolation); and group 3: TLM performed by specialists of islet isolation (Noguchi and Matsumoto). There were no significant differences between groups 1 and 2, whereas islet yields were significantly higher in group 3 compared with either group 1 or 2. Our data suggest that exact, complete performance of TLM could improve the outcome of islet isolation and transplantation. In this review, we describe the mechanisms of the TLM, the procedure of preoxygenated TLM, and the several possibilities for the reasons of the discrepancy.

Novel Culture Technique Involving an Histone Deacetylase Inhibitor Reduces the Marginal Islet Mass to Correct Streptozotocin-Induced Diabetes

“…(Kyunggi-do, Korea). All animal experiments were performed in accordance with the protocols apcubation time have been tested to optimize islet yield (19,26,37). Second, several surrogate β-cells have been proved by the Korea University Institutional Animal Care and Experimentation Committee.…”

Luminescence technology in preservation and transplantation for rat islet

“…A large number of reports have shown that the two-layer method, which employs oxygenated perfluorochemical and UW solution, is superior to simple cold storage in UW to preserve not only islets but also the whole pancreas transplantation. 29 However, these reports have utilized short-time cold storage of isolated islets before islet transplantation. This data provides a clear demonstration, for the first time, that ET-K solution is superior for the long-term preservation, and that preserved islets function therapeutically in STZ-induced diabetes mice.…”

Recent progress in pancreatic islet transplantation

“…There were no significant differences between groups 1 and 2 whereas islet yields were significantly higher for group 3 compared with either group 1 or 2. Our data suggest that performance of TLM by experts could improve the outcome of islet isolation and transplantation [17] . Interestingly, one of the groups which reported the lack of beneficial effects of TLM found that the PFC-based one-layer method improved islet yield [23] and the isolation index (fragmentation rate of islets, which is calculated as the ratio between islet equivalents and islet number), compared with TLM [24] .…”

“…The two-layer preservation method (TLM), which uses the concept of normobaric oxygenation comprising a cold organ preservation solution (UW solution) with a perfluorochemical (PFC) oxygen carrier solution, with the pancreas being suspended between the two immiscible layers, has been utilized for many clinical trials of islet transplantation [17][18][19][20] . However, two recent largescale studies showed no beneficial effect of TLM, compared with UW storage, on human islet isolation and transplantation [21,22] .…”