Pancreas preservation for pancreas and islet transplantation

Yasuhiro Iwanaga, David E.R. Sutherland, James V. Harmon, Klearchos K. Papas

Research output: Contribution to journalReview article

44 Scopus citations

Abstract

PURPOSE OF REVIEW: To summarize advances and limitations in pancreas procurement and preservation for pancreas and islet transplantation, and review advances in islet protection and preservation. RECENT FINDINGS: Pancreases procured after cardiac death, with in-situ regional organ cooling, have been successfully used for islet transplantation. Colloid-free Celsior and histidine-tryptophan-ketoglutarate preservation solutions are comparable to University of Wisconsin solution when used for cold storage before pancreas transplantation. Colloid-free preservation solutions are inferior to University of Wisconsin solution for pancreas preservation prior to islet isolation and transplantation. Clinical reports on pancreas transplants suggest that the two-layer method may not offer significant benefits over cold storage with the University of Wisconsin solution: improved oxygenation may depend on the graft size; benefits in experimental models may not translate to human organs. Improvements in islet yield and quality occurred from pancreases treated with inhibitors of stress-induced apoptosis during procurement, storage, isolation or culture desirable before islet isolation and transplantation and may improve islet yield and quality. Methods for real-time, noninvasive assessment of pancreas quality during preservation have been implemented and objective islet-potency assays have been developed and validated. These innovations should contribute to objective evaluation and establishment of improved pancreas-preservation and islet-isolation strategies. SUMMARY: Cold storage may be adequate for preservation before pancreas transplants, but insufficient when pancreases are processed for islets or when expanded donors are used. Supplementation of cold-storage solutions with cytoprotective agents and perfusion may improve pancreas and islet transplant outcomes.

Original languageEnglish (US)
Pages (from-to)135-141
Number of pages7
JournalCurrent Opinion in Organ Transplantation
Volume13
Issue number2
DOIs
StatePublished - Apr 1 2008

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Keywords

  • Islet isolation
  • Islet transplants
  • Pancreas preservation
  • Pancreas procurement
  • Pancreas transplants

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