The Standardization of Pancreatic Donors for Islet Isolations

O’Gorman, Doug; Kin, Tatsuya; Murdoch, Travis B.; Richer, Brad; McGhee-Wilson, Deborah; Ryan, Edmond A.; Shapiro, James; Lakey, Jonathan R.T.

doi:10.1097/01.tp.0000172216.47547.d5

Cited by 88 publications

(70 citation statements)

References 23 publications

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“…Despite the limitations of our study's design and the skewed allocation of donors within both groups, the interim analysis after one year showed a highly significant difference (Pϭ0.01) in the primary and clinically relevant endpoint of our study between the two solutions. From 19 pancreata procured in UW perfused donors, 13 islet preparations could effectively be transplanted, a figure similar to other experimented islet isolation centers (3,4). Importantly, the quality of these preparations has been further confirmed by their excellent primary and long-term function after transplantation in Type 1 diabetic recipients.…”

Section: Discussionmentioning

confidence: 78%

“…Routine human islet isolation remains however a major and frustrating challenge (2). In most centers, barely half of the processed pancreata effectively reach the threshold for clinical transplantation (3,4). Optimizing the use of the scarce available organs and limited human and financial resources by increasing the consistency of the procedure appears therefore essential (5).…”

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confidence: 99%

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Influence of Preservation Solution on Human Islet Isolation Outcome

Hübert

Gmyr²,

Arnalsteen³

et al. 2007

Transplantation

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Our results suggest that colloid-free preservation solutions might be suboptimal for pancreas perfusion and cold storage prior to islet isolation and transplantation. Because pancreata are now frequently recovered for islet transplantation, preliminary experimental and clinical data about islet isolation should be obtained prior to the routine implementation of new preservation solutions for abdominal perfusion during multiorgan recovery.

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Section: Discussionmentioning

confidence: 78%

mentioning

confidence: 99%

Influence of Preservation Solution on Human Islet Isolation Outcome

Hübert

Gmyr²,

Arnalsteen³

et al. 2007

Transplantation

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“…However, it is still difficult to recover the entire quantity of islets contained in a pancreas. Indeed, even in the leading centers, a transplantable yield of isolated islets is obtained from less than 50% of the pancreases processed (1,2). A major obstacle to successful human islet isolation has been the variability of the collagenase digestion phase of islet isolation.…”

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confidence: 97%

Factors Influencing the Collagenase Digestion Phase of Human Islet Isolation

Kin

Johnson²,

Shapiro³

et al. 2007

Transplantation

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Substantial advances in human islet isolation technology have occurred during the past decade. However, it is still difficult to recover the entire quantity of islets contained in a pancreas. A major obstacle to successful human islet isolation has been the variability of the collagenase digestion phase of islet isolation. Future advances in enzyme technology will make it possible to optimally liberate islets with enzyme blends "tailor-made" for each individual donor pancreas. Such innovative strategies will be advantageous in improving islet isolation efficiency, recovery, viability, and ultimately posttransplant function.

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“…Similarly, there have been experimental isolations with glands from non-heartbeating donors [39 ]. The increased use of pancreas preservation methods, such as protease inhibitor infusion and the twolayer preservation method, as well as scoring systems for predicting favorable outcomes of islet isolations have been credited with allowing the use of glands from what would otherwise be marginal donors [40 ].…”

Section: Improving the Processmentioning

confidence: 99%

The state of islet transplantation

Gaglia¹

2006

Current Opinion in Internal Medicine

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Purpose of reviewThe field of clinical islet transplantation has seen a recent crescendo of interest. This review will describe the current state of islet transplantation, with particular emphasis on its use in the treatment of type 1 diabetes, and provide insight into the barriers preventing widespread clinical application. Recent findingsIslet transplantation is considered a promising potential therapy for patients with type 1 diabetes mellitus. It offers an attractive alternative to exogenous insulin with potentially fewer complications and a larger supply of donor material than is available for solid organ pancreas transplant. Since the 2000 announcement of 100% insulin independence in seven patients from the center in Edmonton, high rates of initial insulin independence have been achieved at other centers. There have been improvements in donor selection and islet processing, expanding potential applications. Longer-term follow-up studies showing the duration of insulin independence, graft function, and effects on diabetic complications are now being reported. Summary Although clinical islet transplantation remains limited to research trials, more centers are demonstrating high rates of initial insulin independence. Glycemic control, beta cell reserve, and longer-term insulin independence appears inferior to that seen with whole-pancreas transplant. Even in insulin-dependent recipients, however, preliminary data show beneficial effects on both acute and long-term diabetes complications as long as appreciable C-peptide is detectable from the grafts.

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The Standardization of Pancreatic Donors for Islet Isolations

Abstract: This scoring system has proven to be useful in guiding the decision process as to whether to accept a particular pancreas for a favorable isolation outcome.

Cited by 88 publications

References 23 publications

Influence of Preservation Solution on Human Islet Isolation Outcome

Influence of Preservation Solution on Human Islet Isolation Outcome

Factors Influencing the Collagenase Digestion Phase of Human Islet Isolation

The state of islet transplantation

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