Samenvatting

Objective Human donor pancreases can be processed to islet cell grafts but less than 50% of isolates reach quality control criteria for clinical transplantation. Donor, procurement and processing conditions are considered to influence this utility rate. The present study evaluates the subgroup of donors with circulatory death involving euthanasia (DCD-V). This subgroup has been associated with excellent outcome of solid organ transplants. Methods We present a retrospective analysis using our database containing donor and procurement characteristics and quality control data of the isolates. Results Isolates from 13 DCD-V pancreases were compared with those from our reference cohort of donors after brain death (DBD, n=614) and donors after controlled circulatory death (DCD-III, n=142). Their beta cell yield was not significantly higher than in DBD but higher than in DCD-III (p<0.05). The insulin content of the isolated beta cells was higher than in DBD and in DCD-III isolates (22±4.4 vs 16±0.4 and 15±0.9 µg insulin/106 beta cells; p<0.05). Most DCD-V isolates were used to prepare a clinical graft, markedly more than for the other donor types (92% versus 42% DBD and 34% DCD-III, p<0.01). The better parameters for DCD-V-pancreatic islet cell isolates can be attributed to more optimal procurement conditions with shorter extraction, warm and cold ischemia times (all p<0.01 versus other groups); the DCD-V donors also exhibited lower glycemia, glycosylated haemoglobin, plasma liver enzymes (all p<0.01 versus other groups) and lower plasma lipase (p<0.05). Conclusions This study demonstrates that more optimal donor and procurement conditions, such as following donation after euthanasia, allow to increase the clinical transplant utility rate of pancreatic islet cell isolates from less than 50% to 92%.
Originele taal-2English
StatusPublished - 14 mrt 2019
EvenementBelgian Transplantation Society - Antwerp, Belgium
Duur: 14 mrt 201914 mrt 2019

Conference

ConferenceBelgian Transplantation Society
Land/RegioBelgium
StadAntwerp
Periode14/03/1914/03/19

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