TY - JOUR
T1 - Key factors for human islet isolation and clinical transplantation
AU - Goto, M.
AU - Johansson, U.
AU - Eich, T. M.
AU - Lundgrem, T.
AU - Engkvist, M.
AU - Felldin, M.
AU - Foss, A.
AU - Kallen, R.
AU - Salmela, K.
AU - Tibell, A.
AU - Tufveson, G.
AU - Nilsson, B.
AU - Korsgren, O.
N1 - Funding Information:
Supported by grants from the Swedish Medical Research Council (16P-13568 and 16X-12219), the Åke Wiberg Foundation, the Nordic Insulin Fund, the Torsten and Ragnar Soderbergs Foundation, the Ernfors Family Fund, Barn Diabetes Fonden, the Swedish Diabetes Association, the Juvenile Diabetes Foundation International, the Knut and Alice Wallenberg Foundation, and the Novo Nordic Foundation.
PY - 2005/3
Y1 - 2005/3
N2 - Background. To further improve the outcome of clinical islet transplantation analysis of the impact of donor- and process-related factors could be of great importance. Materials and Methods. Thirty-eight consecutive clinical islet transplantations were performed with consecutive islet isolations. Univariate analysis for donor- and isolation-related variables were correlated with recipient C-peptide levels at 2 and 4 weeks after transplantation. "Warm ischemia time" was defined as the time from start of University of Wisconsin solution perfusion in the donor until the pancreas was removed to the back table. Results. Short "warm ischemia time" (WIT), low expression of tissue factor (TF) in pancreatic tissue, and high creatinine levels in the donor were variables related to high C-peptide values after islet transplantation. Furthermore, hospitalization length longer than 4 days was associated with low C-peptide levels. The number of islet equivalents (IEQ) did not correlate with the clinical outcome, possibly due to the fact that IEQ number was included in the release criteria for clinical islet transplantation Conclusions. Successful clinical islet transplantation is strongly correlated with donor and pancreas procurement factors rather than isolation process-related variables. "WIT" may induce TF expression in the pancreatic tissues. TF has been identified as the main trigger of the instant blood-mediated-inflammatory reaction in clinical islet transplantation. Therefore, assay of TF expression in pancreatic tissues could be applied as useful screening tool to identify "good" pancreata for clinical transplantation.
AB - Background. To further improve the outcome of clinical islet transplantation analysis of the impact of donor- and process-related factors could be of great importance. Materials and Methods. Thirty-eight consecutive clinical islet transplantations were performed with consecutive islet isolations. Univariate analysis for donor- and isolation-related variables were correlated with recipient C-peptide levels at 2 and 4 weeks after transplantation. "Warm ischemia time" was defined as the time from start of University of Wisconsin solution perfusion in the donor until the pancreas was removed to the back table. Results. Short "warm ischemia time" (WIT), low expression of tissue factor (TF) in pancreatic tissue, and high creatinine levels in the donor were variables related to high C-peptide values after islet transplantation. Furthermore, hospitalization length longer than 4 days was associated with low C-peptide levels. The number of islet equivalents (IEQ) did not correlate with the clinical outcome, possibly due to the fact that IEQ number was included in the release criteria for clinical islet transplantation Conclusions. Successful clinical islet transplantation is strongly correlated with donor and pancreas procurement factors rather than isolation process-related variables. "WIT" may induce TF expression in the pancreatic tissues. TF has been identified as the main trigger of the instant blood-mediated-inflammatory reaction in clinical islet transplantation. Therefore, assay of TF expression in pancreatic tissues could be applied as useful screening tool to identify "good" pancreata for clinical transplantation.
UR - http://www.scopus.com/inward/record.url?scp=17844390407&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=17844390407&partnerID=8YFLogxK
U2 - 10.1016/j.transproceed.2004.11.042
DO - 10.1016/j.transproceed.2004.11.042
M3 - Article
C2 - 15848708
AN - SCOPUS:17844390407
VL - 37
SP - 1315
EP - 1316
JO - Transplantation Proceedings
JF - Transplantation Proceedings
SN - 0041-1345
IS - 2
ER -