CLINICAL APPLICATION OF THE TWO-LAYER [UNIVERSITY OF WINSONSIN SOLUTOIN (UW)/PERFLUOROCHEMICAL (PFC)] METHOD OF PANCREAS PRESERVATION BEFORE TRANSPLANTATION.

Abstract

435 Pancreas preservation after procurement is essential for pancreas transplantation. Currently, simple storage in University of Wisconsin (UW) solution is the standard preservation method, however, it can only preserve the human pancreas for less than 30 hours. If we can preserve the pancreas longer not only we will have more time to prepare for organ transplantation but also the donor organ pool will increase and alleviate shortages. In previous studies, the two-layer method for pancreas preservation has been demonstrated to be superior to UW storage using canine models. The purpose of this study is to confirm the clinical significance of the two-layer method compared with UW storage alone before pancreas transplantation. Methods. From October 1997 to November 1998 we performed 54 pancreas transplants using pancreases from local OPO's. Pancreases were placed in the two-layer method in 10 cases and UW alone in 44 cases prior to transplantation. We compared the condition of grafts at the time of reperfusion, graft function and complications 3 months post-transplantation. In addition, after preservation we collected preservation fluid to examine the bacterial contamination. Results. There was no significant difference between the demographics of donors and recipients as well as no bacterial contamination in any of the donor organs. Total cold ischemia time was 16.5 ± 5.0 hr in the two-layer group and 18.1 ± 4.7 hrs in the UW group with no statistical difference. At the time of reperfusion no grafts in the two-layer group were edematous compared with 10 of 43 (23.3%) in the UW group. All grafts in two-layer group remained soft, compared with 38 of 43 (88.3%) in the UW group at the time of reperfusion. Seven of 10 (70%) grafts obtained the best overall score in the two-layer group and 24 of 42 (57.1%) in the UW group. Nine of 10 (90%) patients in the two-layer group were insulin independent during hospitalization compared with 31 of 44 (70.5%) in the UW group. No patients in two-layer group rejected their grafts compared with 7 of 44 (15.9%) in the UW group. Conclusions. The two-layer method of pancreas preservation could be beneficial in clinical transplantation being that it was superior to UW in both morphological and functional assessment.