Human islet transplantation from pancreases with prolonged cold ischemia using additional preservation by the two-layer (UW solution/perfluorochemical) cold-storage method
Human islet transplantation from pancreases with prolonged cold ischemia using additional preservation by the two-layer (UW solution/perfluorochemical) cold-storage method
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DOI：
10.1097/00007890-200212270-00007
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发表时间：
2002-12
期刊：
影响因子：
6.2
通讯作者：
T. Tsujimura;Y. Kuroda;T. Kin;J. Avila;R. Rajotte;G. Korbutt;E. Ryan;A. M. Shapiro;J. Lakey
中科院分区：
文献类型：
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作者：
T. Tsujimura;Y. Kuroda;T. Kin;J. Avila;R. Rajotte;G. Korbutt;E. Ryan;A. M. Shapiro;J. Lakey
背景资料。一种双层(威斯康星大学溶液/全氟化学[UW/PFC])冷藏方法在保存过程中向胰腺提供足够的氧气，并修复缺血损伤的胰腺。在本研究中，我们确定了两层法额外保存是否能提高在UW中长期冷藏的人胰腺的复苏率。方法：研究方法。人胰腺取自身体器官供体，冷藏11.8±1.5小时(UW/PFC组，n=7)，冷藏11.3±0.3小时(UW/PFC组，n=14)，4℃保存2.9±0.7小时。选定的胰腺符合在华盛顿大学至少冷藏10小时的标准。所有患者均采用Liberase经导管注入Pefabloc、温和机械分离、Ficoll梯度纯化的标准方案进行处理。按照Edmonton方案的标准选择移植的胰岛(5,000个胰岛当量[IE]/公斤受体体重)。结果。胰岛恢复率UW/PFC组显著高于UW组(分别为349.2±44.1×10~3和214.0±31.0×10~3 IE，P<0.05)。胰岛产量UW/PFC组为4.6±1.0×103IE/g，UW组为2.0±0.3×103IE/g(P<；0.05)。UW/PFC组7例中5例(71%)移植成功，UW组14例中5例(36%)移植成功。UW/PFC组的胰岛移植改善了所有受者的血糖控制能力，减少了外源性胰岛素的应用。结论。在胰岛分离和移植前保存和恢复缺血损伤的人胰腺的方法的改进，可能对临床胰岛移植领域非常有利。初步研究表明，二层(UW/PFC)冷冻法附加短期保存能显著提高胰岛复苏率，增加人胰腺冷缺血后胰岛移植的机会。
Background. A two-layer (University of Wisconsin solution/perfluorochemical [UW/PFC]) cold-storage method delivers sufficient oxygen to the pancreas during preservation and restores the ischemically damaged pancreas. In this study, we determined whether the additional preservation by the two-layer method could improve islet recovery from human pancreases with prolonged cold storage in UW. Methods. Human pancreases were procured from cadaveric organ donors and preserved by the two-layer method (UW/PFC) for 2.9±0.7 hours (mean±SEM) at 4°C after 11.8±1.5 hours of cold storage in UW (UW/PFC group, n=7), or by cold UW alone for 11.3±0.3 hours (UW group, n=14). The selected pancreases met the criteria of having at least 10 hours of cold storage in UW. All were processed by using a standard protocol of Liberase perfusion with Pefabloc by way of the duct, gentle mechanical dissociation, and Ficoll gradient purification. Transplanted islets were selected with the criteria of the Edmonton protocol (>5,000 islet equivalents [IE]/kg recipient body weight). Results. The islet recovery was significantly increased in the UW/PFC group compared with the UW group (349.2±44.1×103 and 214.0±31.0×103 IE, respectively;P <0.05). This resulted in islet yields of 4.6±1.0×103 IE/g of pancreas in the UW/PFC group compared with 2.0±0.3×103 IE/g of pancreas in the UW group (P <0.05). Five of 7 cases (71%) in the UW/PFC group and 5 of 14 cases (36%) in the UW group were transplanted. The islet grafts in the UW/PFC group improved the ability of glycemic control and decreased exogenous insulin administration in all recipients. Conclusions. Improvements in methods to preserve and recover ischemically damaged human pancreases before islet isolation and transplant could be extremely beneficial to the field of clinical islet transplantation. This preliminary study shows that additional short preservation by the two-layer (UW/PFC) cold-storage method can significantly improve islet recovery and increase opportunities of islet transplantation from human pancreases after prolonged cold ischemia.