TY - JOUR
T1 - Abdominal normothermic regional perfusion after donation after circulatory death improves pancreatic islet isolation yield
AU - Doppenberg, Jason B.
AU - van Rooden, Rutger M.
AU - van Dijk, Madeleine C.
AU - de Goeij, Femke H.C.
AU - van der Heijden, Fenna J.
AU - Alwayn, Ian P.J.
AU - de Koning, Eelco J.P.
AU - de Jonge, Jeroen
AU - Engelse, Marten A.
AU - Huurman, Volkert A.L.
N1 - Publisher Copyright: © 2024 The Authors
PY - 2025/3
Y1 - 2025/3
N2 - Abdominal normothermic regional perfusion (aNRP) is an in situ normothermic oxygenated donor perfusion technique before procurement during controlled donation after circulatory death (cDCD) procedures and allows for organ quality evaluation. There are few data on the effect of aNRP on pancreatic islet isolation and subsequent transplantation outcomes. We aim to evaluate the impact of aNRP on cDCD pancreatic islet isolation and transplantation. A retrospective analysis was performed on pancreatic islet isolation outcomes from aNRP, cDCD, and donation after brain death pancreases. Isolations were compared to previous donor age (60-75 years) matched isolations. Islet function was assessed by a dynamic glucose-stimulated insulin secretion. Donor baseline characteristics did not differ among groups. Isolations from aNRP pancreases (471 739 islet equivalents [IEQ] [655 435-244 851]) yielded more islets compared to cDCD (218 750 IEQ [375 951-112 364], P <.01) and to donation after brain death (206 522 IEQ [385 544-142 446], P =.03) pancreases. Dynamic glucose-stimulated insulin secretion tests in 7 aNRP islet preparations showed a mean stimulation index of 4.91, indicating good functionality. Bilirubin and alanine aminotransferase during aNRP correlated with islet yield (r2 = 0.685, P =.002; r2 = 0.491, P =.016, respectively). Islet isolation after aNRP in cDCD donors results in a high islet yield with viable functional islets. aNRP could increase the utilization of the pancreases for islet transplantation.
AB - Abdominal normothermic regional perfusion (aNRP) is an in situ normothermic oxygenated donor perfusion technique before procurement during controlled donation after circulatory death (cDCD) procedures and allows for organ quality evaluation. There are few data on the effect of aNRP on pancreatic islet isolation and subsequent transplantation outcomes. We aim to evaluate the impact of aNRP on cDCD pancreatic islet isolation and transplantation. A retrospective analysis was performed on pancreatic islet isolation outcomes from aNRP, cDCD, and donation after brain death pancreases. Isolations were compared to previous donor age (60-75 years) matched isolations. Islet function was assessed by a dynamic glucose-stimulated insulin secretion. Donor baseline characteristics did not differ among groups. Isolations from aNRP pancreases (471 739 islet equivalents [IEQ] [655 435-244 851]) yielded more islets compared to cDCD (218 750 IEQ [375 951-112 364], P <.01) and to donation after brain death (206 522 IEQ [385 544-142 446], P =.03) pancreases. Dynamic glucose-stimulated insulin secretion tests in 7 aNRP islet preparations showed a mean stimulation index of 4.91, indicating good functionality. Bilirubin and alanine aminotransferase during aNRP correlated with islet yield (r2 = 0.685, P =.002; r2 = 0.491, P =.016, respectively). Islet isolation after aNRP in cDCD donors results in a high islet yield with viable functional islets. aNRP could increase the utilization of the pancreases for islet transplantation.
UR - http://www.scopus.com/inward/record.url?scp=85207155763&partnerID=8YFLogxK
U2 - 10.1016/j.ajt.2024.09.034
DO - 10.1016/j.ajt.2024.09.034
M3 - Article
C2 - 39366509
AN - SCOPUS:85207155763
SN - 1600-6135
VL - 25
SP - 594
EP - 601
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 3
ER -