Balamurugan A N, Chang Y, Bertera S, Sands A, Shankar V, Trucco M, Bottino R
Thomas E. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Diabetologia. 2006 Aug;49(8):1845-54. doi: 10.1007/s00125-006-0318-0. Epub 2006 Jun 17.
AIMS/HYPOTHESIS: The limited availability of deceased donor pancreases suitable for pancreas and islet transplantation calls for a broader utilisation of donor tissue for transplantation purposes. Young donors, representing, fortunately, a minor but significant pool of individuals, have been largely under-employed, mainly because of anatomical and functional incompatibilities with potential recipients. For islet transplantation, the isolation of pancreatic islets from young donors rarely occurs, because of technical problems. As a result of the peculiar characteristics of young donor pancreases, the standard isolation procedure does not allow efficient separation of the islets from the surrounding exocrine tissue, and favours the generation of mantled islets. Nonetheless, young donor islets offer high qualitative and clinically appealing characteristics.
We standardised a modified methodology to obtain purified and mantle-free human islets from young donors. This method principally involves efficient delivery of isolation enzyme with reduced mechanical disruption of the pancreas combined with additional filtration steps.
We were able to obtain purified and mantle-free human islets from donors as young as 6 months of age with good morphological and functional properties. The good qualitative characteristics of the islets, evidenced in vitro, were proven in vivo, as they were qualitatively superior to islets of older donors in transplantation studies.
CONCLUSIONS/INTERPRETATION: This study justifies the utilisation of islets derived from young donors for islet transplantation.
目的/假设：适合胰腺和胰岛移植的已故供体胰腺供应有限，这就需要更广泛地利用供体组织用于移植目的。年轻供体幸运地代表了一小部分但很重要的个体群体，在很大程度上未得到充分利用，主要是因为其在解剖结构和功能上与潜在受体不匹配。对于胰岛移植，由于技术问题，很少从年轻供体中分离胰岛。由于年轻供体胰腺的特殊特征，标准分离程序无法有效地将胰岛与周围的外分泌组织分离，并且有利于形成被膜胰岛。尽管如此，年轻供体的胰岛具有高质量和临床上吸引人的特征。
我们标准化了一种改良方法，以从年轻供体中获得纯化且无被膜的人胰岛。该方法主要包括有效地输送分离酶，同时减少对胰腺的机械破坏，并结合额外的过滤步骤。
我们能够从年仅6个月大的供体中获得具有良好形态和功能特性的纯化且无被膜的人胰岛。胰岛在体外显示出的良好质量特性在体内也得到了证实，因为在移植研究中，它们在质量上优于年长供体的胰岛。
结论/解读：本研究证明了利用年轻供体的胰岛进行胰岛移植是合理的。
