Successful Cold Storage Preservation of Canine Pancreas With Uw-1 Solution Prior to Islet Isolation

Zucker, Peter; Bloom, Allen D.; Strasser, Sheryl; Alejandro, Rodolfo

doi:10.1097/00007890-198907000-00045

Cited by 16 publications

(12 citation statements)

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“…University of Wisconsin solution (UWS) has been the standard preservation solution for pancreas transplantation for almost 20 years [36]. Recently, multiple reports have suggested that other preservation solutions may be effective alternatives to UWS [18][19][20]22•].…”

Section: Pancreas Preservation For Pancreas Transplantationmentioning

confidence: 99%

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Pancreas preservation for pancreas and islet transplantation

Iwanaga

Sutherland

Harmon

et al. 2008

Current Opinion in Organ Transplantation

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Purpose of review-To summarize advances and limitations in pancreas procurement and preservation for pancreas and islet transplantation, and review advances in islet protection and preservation.Recent findings-Pancreases procured after cardiac death, with in-situ regional organ cooling, have been successfully used for islet transplantation. Colloid-free Celsior and histidinetryptophan-ketoglutarate preservation solutions are comparable to University of Wisconsin solution when used for cold storage before pancreas transplantation. Colloid-free preservation solutions are inferior to University of Wisconsin solution for pancreas preservation prior to islet isolation and transplantation. Clinical reports on pancreas and islet transplants suggest that the two-layer method may not offer significant benefits over cold storage with the University of Wisconsin solution: improved oxygenation may depend on the graft size; benefits in experimental models may not translate to human organs. Improvements in islet yield and quality occurred from pancreases treated with inhibitors of stress-induced apoptosis during procurement, storage, isolation or culture. Pancreas perfusion may be desirable before islet isolation and transplantation and may improve islet yields and quality. Methods for real-time, noninvasive assessment of pancreas quality during preservation have been implemented and objective islet potency assays have been developed and validated. These innovations should contribute to objective evaluation and establishment of improved pancreas preservation and islet isolation strategies.Summary-Cold storage may be adequate for preservation before pancreas transplants, but insufficient when pancreases are processed for islets or when expanded donors are used. Supplementation of cold storage solutions with cytoprotective agents and perfusion may improve pancreas and islet transplant outcomes.

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Section: Pancreas Preservation For Pancreas Transplantationmentioning

confidence: 99%

“…UWS has been used since the 1980s as the pancreas preservation solution [36] for clinical islet transplants. Salehi et al [37•] recently reported that islet yields from human pancreases preserved in HTK or UWS were equivalent.…”

Section: Pancreas Preservation For Islet Transplantationmentioning

confidence: 99%

Pancreas preservation for pancreas and islet transplantation

Iwanaga

Sutherland

Harmon

et al. 2008

Current Opinion in Organ Transplantation

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“…The two main methods used for experimental and clinical organ preservation are static cold storage, which we will simply refer to as cold storage, and machine perfusion [10–20,21•,22•,23–34,35•,36,37•,38–44]. The hypothermic pulsatile machine perfusion technique originally developed by Carrel and Lindbergh in 1935 [45–47] has been widely used for clinical kidney transplants [48] but not for clinical pancreas preservation.…”

Section: Pancreas Preservation For Pancreas Transplantationmentioning

confidence: 99%

Section: Pancreas Preservation For Pancreas Transplantationmentioning

confidence: 99%

Pancreas preservation for pancreas and islet transplantation

Iwanaga

Sutherland

Harmon

et al. 2008

Current Opinion in Organ Transplantation

View full text Add to dashboard Cite

Purpose of review To summarize advances and limitations in pancreas procurement and preservation for pancreas and islet transplantation, and review advances in islet protection and preservation. Recent findings Pancreases procured after cardiac death, with in-situ regional organ cooling, have been successfully used for islet transplantation. Colloid-free Celsior and histidine-tryptophan-ketoglutarate preservation solutions are comparable to University of Wisconsin solution when used for cold storage before pancreas transplantation. Colloid-free preservation solutions are inferior to University of Wisconsin solution for pancreas preservation prior to islet isolation and transplantation. Clinical reports on pancreas and islet transplants suggest that the two-layer method may not offer significant benefits over cold storage with the University of Wisconsin solution: improved oxygenation may depend on the graft size; benefits in experimental models may not translate to human organs. Improvements in islet yield and quality occurred from pancreases treated with inhibitors of stress-induced apoptosis during procurement, storage, isolation or culture. Pancreas perfusion may be desirable before islet isolation and transplantation and may improve islet yields and quality. Methods for real-time, noninvasive assessment of pancreas quality during preservation have been implemented and objective islet potency assays have been developed and validated. These innovations should contribute to objective evaluation and establishment of improved pancreas preservation and islet isolation strategies. Summary Cold storage may be adequate for preservation before pancreas transplants, but insufficient when pancreases are processed for islets or when expanded donors are used. Supplementation of cold storage solutions with cytoprotective agents and perfusion may improve pancreas and islet transplant outcomes.

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“…The Euro-Collins solution initially introduced in 1991 as a solvent of Ficoll prevented cold storage oedema of exocrine tissue and improved yield of islet isolation [26]. Around the same time, the UW (University of Wisconsin) solution was introduced as a transport media for pancreases destined for the islet isolation laboratory [27]. Cold storage of pancreas for up to 26 h was reported to yield viable islets [28].…”

Section: Islet Isolation and Donor Considerationsmentioning

confidence: 99%

Current status of pancreatic islet transplantation

2006

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DM (diabetes mellitus) is a metabolic disorder of either absolute or relative insulin deficiency. Optimized insulin injections remain the mainstay life-sustaining therapy for patients with T1DM (Type I DM) in 2006; however, a small subset of patients with T1DM (approx. 10%) are exquisitely sensitive to insulin and lack counter-regulatory measures, putting them at higher risk of neuroglycopenia. One alternative strategy to injected insulin therapy is pancreatic islet transplantation. Islet transplantation came of age when Paul E. Lacy successfully reversed chemical diabetes in rodent models in 1972. In a landmark study published in 2000, Shapiro et al. [A. M. Shapiro, J. R. Lakey, E. A. Ryan, G. S. Korbutt, E. Toth, G. L. Warnock, N. M. Kneteman and R. V. Rajotte (2000) N. Engl. J. Med. 343, 230-238] reported seven consecutive patients treated with islet transplants under the Edmonton protocol, all of whom maintained insulin independence out to 1 year. Substantial progress has occurred in aspects of pancreas procurement, transportation (using the oxygenated two-layer method) and in islet isolation (with controlled enzymatic perfusion and subsequent digestion in the Ricordi chamber). Clinical protocols to optimize islet survival and function post-transplantation improved dramatically with the introduction of the Edmonton protocol, but it is clear that this approach still has potential limitations. Newer pharmacotherapies and interventions designed to promote islet survival, prevent apoptosis, to promote islet growth and to protect islets in the long run from immunological injury are rapidly approaching clinical trials, and it seems likely that clinical outcomes of islet transplantation will continue to improve at the current exponential pace.

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Successful Cold Storage Preservation of Canine Pancreas With Uw-1 Solution Prior to Islet Isolation

Cited by 16 publications

References 0 publications

Pancreas preservation for pancreas and islet transplantation

Pancreas preservation for pancreas and islet transplantation

Pancreas preservation for pancreas and islet transplantation

Current status of pancreatic islet transplantation

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