KEY FACTORS FOR HUMAN ISLET ISOLATION AND CLINICAL TRANSPLANTATION

Abstract

P454 Aims: To further increase the success rate of clinical islet transplantation analysis of the impact of donor- and process- related factors could be of great importance. Human pancreata were retrieved from organ donors applying no other exclusion than usually applied for kidney donors. Methods: One hundred twelve standardized consecutive islet isolations, of which 29 were used for clinical islet transplantation, were evaluated. Both univariate and multivariate regression analysis for donor- and process- related variables were correlated to the possibility to proceed to clinical transplantation and to the C-peptide levels of the recipients 2 weeks after transplantation. Results: Multivariate regression analysis identified maximal recorded amylase ≥100 U/l (p=0.03), low BMI (p=0.03), and the use of catecholamine (p=0.04) as crucial donor-related factors related to unsuccessful islet isolation. In addition, short cold ischemia time (p=0.005), applying a dissection technique enabling the use of the whole pancreas (p=0.02), and local procurement team (p=0.03) were identified as isolation-related variables related to successful islet isolation. Furthermore, short hospitalization length (p=0.01), the use of furosemide (p=0.01), low expression of monocyte chemoattractant protein (MCP)-1 in pancreatic tissue (p=0.02), maximal recorded amylase <100 U/l (p=0.03) and short warm ischemia time (p=0.03) were identified as factors associated to high C-peptide values 2 weeks after islet transplantation. Conclusions: The success rate of islet isolation and clinical transplantation is strongly correlated to both donor and pancreas procurement factors. Many of these adverse factors would most likely be possible to reverse by optimal management of the donor.