Human Pancreas Preservation Prior to Islet Isolation

Abstract

Islet transplantation has become a feasible treatment option for patients with type 1 diabetes mellitus after improvements regarding less diabetogenic immunosuppression and preparation of sufficient quantities of highly viable islets for transplantation. While the current techniques of multiorgan harvesting and transportation of organs to distant hospitals often result in 12 h or more of cold storage time before transplantation, University of Wisconsin (UW) solution has proven to be effective in pancreas preservation, leading to successful clinical whole pancreas transplantation, and human pancreatic grafts can be preserved by UW solution for periods exceeding 24 h. In the case of clinical islet transplantation, however, prolonged cold ischemia in UW solution before islet isolation significantly reduced recovery of viable islets, and it is still difficult to recover sufficient numbers of islets from a single cadaveric donor pancreas to achieve insulin independence after transplantation. Therefore, preservation of the pancreas has been an important factor in the subsequent success of clinical islet transplantation. We review pancreas preservation prior to islet isolation and discuss a two-layer (UW solution/perfluorochemical) cold storage method of the human pancreas as a potential method for pancreas rescue.