A Meta-Analysis for Comparison of the Two-Layer and University of Wisconsin Pancreas Preservation Methods in Islet Transplantation
A Meta-Analysis for Comparison of the Two-Layer and University of Wisconsin Pancreas Preservation Methods in Islet Transplantation
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DOI：
10.3727/096368910x544942
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发表时间：
2011-08
影响因子：
3.3
通讯作者：
Huanying Qin;S. Matsumoto;G. Klintmalm;E. De Vol
中科院分区：
文献类型：
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作者：
Huanying Qin;S. Matsumoto;G. Klintmalm;E. De Vol
已经报道了两层方法（TLM）与威斯康星州大学（UW）方法相比保存胰腺的有效性的验证结果。本研究的目的是汇编支持或反对这两种方法在人胰岛产量和活力方面存在任何差异的证据。对PubMed（2000年1月至2008年5月）和Cochran图书馆进行检索，纳入17项研究进行荟萃分析。提取了供体特征、保存时间和结局的数据。根据TLM的使用方式（UW + TLM或单独使用TLM）、平均冷缺血时间（CIT）（>20 h或<20 h）以及是否使用特殊化学品（是或否）对研究进行亚组。对所有研究和亚组进行荟萃分析，并报告合并标准化平均差异（SMD）和95%置信区间（CI）。总体而言，TLM的使用显著增加了胰岛产量[SMD，0.74（0.44-1.04）]和活力[SMD，0.63（0.14-1.12）]。当在UW储存后使用TLM或当使用延长的CIT时，TLM对胰岛产量的有益作用更明显。单独使用TLM、缩短CIT和不使用化学品均导致TLM和UW组之间的胰岛活力相似。只有当TLM在UW储存后使用，或与延长的CIT，或与化学品使用时，TLM对胰岛活力的有益作用才得到证明。总之，TLM有利于在人胰岛分离之前延长胰腺保存;然而，TLM用于短期保存的益处尚不清楚。
Conflicting results have been reported on the effectiveness of the two-layer method (TLM) compared with the University of Wisconsin (UW) method for preserving pancreata. The objective of this study was to compile the evidence for or against any difference in human islet yield and viability between these two. PubMed (January 2000 to May 2008) and Cochran Library searches were performed and 17 studies were included for the meta-analysis. Data on donor characteristics, preservation time, and outcomes were abstracted. Studies were subgrouped based on how TLM was used (UW + TLM or TLM alone), on mean cold ischemic time (CIT) (>20 h or <20 h), and on whether special chemical was used (yes or no). Meta-analysis of all studies and subgroups was performed and the pooled standardized mean differences (SMD) with 95% confidence intervals (CI) were reported. Overall, the use of TLM significantly increased islet yield [SMD, 0.74 (0.44–1.04)] and viability [SMD, 0.63 (0.14–1.12)]. The beneficial effects of TLM on islet yield were more evident when TLM was used following UW storage or when prolonged CIT was used. TLM used alone, shorter CIT, and no chemical use all resulted in similar islet viability between TLM and UW groups. Beneficial effects of TLM on islet viability were demonstrated only when TLM was used following UW storage, or with prolonged CIT, or with chemical use. In conclusion, the TLM was beneficial for prolonged pancreas preservation before human islet isolation; however, benefit of the TLM for short-term preservation was not clear.