Positive Sterility Cultures of Transplant Solutions during Pancreatic Islet Autotransplantation Are Associated Infrequently with Clinical Infection

Abstract

In autologous islet preparations, isolation solutions frequently have positive cultures, but this finding is associated infrequently with clinical infection.

The impact of bacterial colonization on graft success after total pancreatectomy with autologous islet transplantation: considerations for early definitive surgical intervention

“…24 Whereas prior studies have demonstrated a preponderance of gram-positive organisms such as staphylococcal, streptococcal, and enterococcal species, five of six patients with bacterial contamination also grew gram-negative bacteria, predominantly Klebsiella pneumoniae. 12,17,18 This dichotomy alone may provide a microbial milieu leading to greater β-cell death and our observed findings of lower islet yield, and higher rates of graft failure than noncontaminated patients.…”

“…Prior to transplantation, established release criteria for islet products must include sterility metrics such as the absence of bacteria on Gram stain and acceptably low levels of endotoxins in the final preparation. Contamination in the pancreatic transport solution is reported as high as 61%‐68% with only 5.5%‐32.3% of final islet preparations growing bacterial contaminants after rigorous GMP isolation and antimicrobial protocols . Our rate of contaminated transportation solution was comparable at 59.3%, and contamination was substantially reduced to 22.2% in the final islet preparation with the aforementioned protocols.…”

“…The bacteria grown in culture were diverse and polymicrobial, and despite all patients passing release criteria with ≤5 EU/kg of endotoxin released, five of six grew gram-negative rods in culture ( Contamination in the pancreatic transport solution is reported as high as 61%-68% with only 5.5%-32.3% of final islet preparations growing bacterial contaminants after rigorous GMP isolation and antimicrobial protocols. 12,[17][18][19] Our rate of contaminated transportation solution was comparable at 59.3%, and contamination was substantially reduced to 22.2% in the final islet preparation with the aforementioned protocols.…”

“…However, in a subset of patients, bacterial contamination remains even after this protocol. Although studies are limited, current data suggest that patients with bacterial contamination infrequently develop culture‐concordant infections and this contamination should not preclude transplantation . The impact of persistent bacterial contamination on graft success is unknown, and the purpose of this study was to determine whether bacterial contamination of the final islet preparation affects rates of insulin independence.…”

Pediatric Autologous Islet Transplantation

“…Fat-soluble vitamins are provided as a water-miscible product. Bacterial contamination of the pancreas or islet product is common; it is treated with antibiotics, but conveys no adverse long-term risk when treated appropriately [31, 32]. Children are managed by a multidisciplinary team on a ward with nurses experienced in the post-operative management of TPIAT.…”