Abstract
Cold ischemia and hence travel time can adversely affect outcomes of islet isolation. The aim of this study was to compare the isolation and transplant outcomes of donor pancreata according to the distance from islet isolation facility. Principally, those within a 50 km radius of the centre were compared with those from regional areas within the state and those from interstate donors within Australia. Organ donors were categorised according to distance from National Pancreas Transplant Unit Westmead (NPTU). Donor characteristics were analysed statistically against islet isolation outcomes. These were age, BMI, cause and mechanism of death, days in ICU, gender, inotrope and steroid use, cold ischemia time (CIT) and retrieval surgical team. Between March 2007 and December 2020, 297 islet isolations were performed at our centre. A total of 149 donor pancreata were local area, and 148 non-local regions. Mean distance from the isolation facility was 780.05 km. Mean pancreas CIT was 401.07 ± 137.71 min and was significantly different between local and non-local groups (297.2 vs. 487.5 min, p < 0.01). Mean age of donors was 45.22 years, mean BMI was 28.82, sex ratio was 48:52 F:M and mean time in ICU was 3.07 days. There was no significant difference between local and non-local for these characteristics. The mean CIT resulting in islet transplantation was 297.1 ± 91.5 min and longest CIT resulting in transplantation was 676 min. There was no significant difference in islet isolation outcomes between local and non-local donors for characteristics other than CIT. There was also no significant effect of distance from the isolation facility on positive islet transplant outcomes (C-peptide > 0.2 at 1 month post-transplant). Conclusions: Distance from the isolation centre did not impact on isolation or transplant outcomes supporting the ongoing nationwide use of shipping pancreata for islet isolation and transplantation.
Highlights
Pancreatic islet cell transplantation has become a successful modality of treatment for a select group of patients with type 1 diabetes. [1,2,3,4]
The aim of this study was to assess whether pancreas dono accessceedntoreustasniddepathtieenltoscfraolmrergegioionnaolfatnhderiusroallaatrieoans ffaacceialitnyumprboervoidf beadrreieqrusitvoaalcecnestsoinugtcomes those macecdeicsaslesderfvriocems (Fthigeulroe c1a).lTrheegaioimn ooffththisestiusodylawtiaosntofaacssileistsyw. hether pancreas donors accessed outside the local region of the isolation facility provided equivalent outcomes to those accessed from the local region of the isolation facility
The ability to access pancreata that are retrieved at a distance from the isolation centre is essential if more patients are to be transplanted
Summary
Pancreatic islet cell transplantation has become a successful modality of treatment for a select group of patients with type 1 diabetes. [1,2,3,4]. In order to provide this service, centralized islet isolation centres need to overcome a number of unique logistical problems, in particular retrieving donor pancreata and transplanting patients from distant areas. In Australia, the problem is acute [5,6] as the service covers an area of 7,692,024 square kilometers, which is approximately twice the size of Europe or three-quarters the size of the United States. [6] Almost one-third of the Australian population lives outside these major urban three transplantation Hospitals—Westmead, St Vincent’s and Queen Elizabeth in Ad laide. [6] Almost one-third of the Australian population lives outside these major urb centres and patients from regional and rural areas face a number of barrier2sotfo13accessin medical services (Figure 1). Distance rings (different areas of shading) are shown radiating from NPTU Westm2e.aRdesSuyldtsney, NSW
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
