Islet isolation from pancreatitis pancreas for islet autotransplantation

A. N. Balamurugan, Gopalakrishnan Loganathan, Amber Lockridge, Sajjad M. Soltani, Joshua J. Wilhelm, Gregory J. Beilman, Bernhard J. Hering, David E R Sutherland

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Citations (Scopus)

Abstract

For patients suffering from intractable chronic pancreatitis, surgical removal of the pancreas may be recommended. While pancreatectomy has the potential to alleviate suffering and prolong life, the induction of iatrogenic diabetes, through the loss of insulin-producing islet cells, becomes an immediate threat to the postoperative patient. Since the procedure was first performed in 1977 at the University of Minnesota, autologous islet transplantation has become the best treatment option to restore a patient’s ability to endogenously regulate their blood sugar. Autologous islet isolation starts with a specific procurement and packaging of the pancreas, which is then transported to a specialized clean-room facility. The pancreas is distended with tissue dissociation enzymes that digest the extracellular matrix of the pancreas, freeing the embedded cells, which are combined into a single tube. If necessary, this tissue is purified by density gradient and the islets transferred to a transplant bag for intraportal infusion back into the patient. The most critical factor for a positive metabolic outcome from this procedure is the islet mass transplanted, making total isolation yield of particular concern. While the pancreas contains an abundance of islets, even the best isolation techniques capture only half of these. Furthermore, patient-donor characteristics and tissue conditions, like fibrosis and cell atrophy, can further diminish islet yields. Our goal at the University of Minnesota has been to research the underlying factors that influence islet yield and viability and to propose specific procedures designed to optimize isolation success regardless of tissue condition. The purpose of this review is to describe our basic protocol as well as to highlight our system of flexible techniques that can be adapted based on an ongoing evaluation of each individual pancreas and the procedural progress itself.

Original languageEnglish (US)
Title of host publicationIslets of Langerhans, Second Edition
PublisherSpringer Netherlands
Pages1199-1227
Number of pages29
ISBN (Electronic)9789400766860
ISBN (Print)9789400766853
DOIs
StatePublished - Jan 1 2015

Fingerprint

Autologous Transplantation
Pancreatitis
Pancreas
Tissue
Clean rooms
Transplants
Medical problems
Blood Glucose
Controlled Environment
Islets of Langerhans Transplantation
Packaging
Pancreatectomy
Chronic Pancreatitis
Product Packaging
Insulin
Islets of Langerhans
Atrophy
Extracellular Matrix
Fibrosis
Enzymes

Keywords

  • Allograft
  • Autograft
  • Autologous islet isolation
  • Chronic pancreatitis
  • Collagenase digestion
  • Human islets
  • Insulin independence
  • Pancreatectomy
  • Transplantation

Cite this

Balamurugan, A. N., Loganathan, G., Lockridge, A., Soltani, S. M., Wilhelm, J. J., Beilman, G. J., ... Sutherland, D. E. R. (2015). Islet isolation from pancreatitis pancreas for islet autotransplantation. In Islets of Langerhans, Second Edition (pp. 1199-1227). Springer Netherlands. https://doi.org/10.1007/978-94-007-6686-0_48

Islet isolation from pancreatitis pancreas for islet autotransplantation. / Balamurugan, A. N.; Loganathan, Gopalakrishnan; Lockridge, Amber; Soltani, Sajjad M.; Wilhelm, Joshua J.; Beilman, Gregory J.; Hering, Bernhard J.; Sutherland, David E R.

Islets of Langerhans, Second Edition. Springer Netherlands, 2015. p. 1199-1227.

Research output: Chapter in Book/Report/Conference proceedingChapter

Balamurugan, AN, Loganathan, G, Lockridge, A, Soltani, SM, Wilhelm, JJ, Beilman, GJ, Hering, BJ & Sutherland, DER 2015, Islet isolation from pancreatitis pancreas for islet autotransplantation. in Islets of Langerhans, Second Edition. Springer Netherlands, pp. 1199-1227. https://doi.org/10.1007/978-94-007-6686-0_48
Balamurugan AN, Loganathan G, Lockridge A, Soltani SM, Wilhelm JJ, Beilman GJ et al. Islet isolation from pancreatitis pancreas for islet autotransplantation. In Islets of Langerhans, Second Edition. Springer Netherlands. 2015. p. 1199-1227 https://doi.org/10.1007/978-94-007-6686-0_48
Balamurugan, A. N. ; Loganathan, Gopalakrishnan ; Lockridge, Amber ; Soltani, Sajjad M. ; Wilhelm, Joshua J. ; Beilman, Gregory J. ; Hering, Bernhard J. ; Sutherland, David E R. / Islet isolation from pancreatitis pancreas for islet autotransplantation. Islets of Langerhans, Second Edition. Springer Netherlands, 2015. pp. 1199-1227
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