Nagata Hideo, Matsumoto Shinichi, Okitsu Teru, Iwanaga Yasuhiro, Noguchi Hirofumi, Yonekawa Yukihide, Kinukawa Tsuneo, Shimizu Tomohiro, Miyakawa Shuichi, Shiraki Ryoichi, Hoshinaga Kiyotaka, Tanaka Koichi
Department of Transplantation and Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Transplantation. 2006 Aug 15;82(3):327-31. doi: 10.1097/01.tp.0000228886.15985.62.
Recent advances in pancreatic islet transplantation (PIT) have contributed significantly to the treatment of patients with type 1 diabetes. The specific aim of this study was to develop an effective technique for the procurement of pancreas for PIT from nonheart-beating-donor (NHBDs).
Between January 2004 and August 2004, eight human pancreata were procured and processed for isolation of islets at a cell processing center. After confirmation of brain death status, a double balloon catheter was inserted to prevent warm ischemic damage to the donor pancreas by using an in situ regional organ cooling system that was originally developed for procurement of kidneys. The catheter position of the cooling system was modified specifically for the pancreas and kidney. Furthermore, we worked in cooperation with a kidney procurement team to protect the pancreas during kidney procurement.
Warm ischemic time could be controlled with the modified in situ regional cooling system at 3.0 +/- 0.8 min (mean +/- SE). The operations for procurement of the kidneys and pancreata lasted 45.6 +/- 3.6 min and 10.6 +/- 1.8 min, respectively. Islet yield per isolation was 444,426 +/- 35,172 IE (islet equivalent). All eight cases met the criteria for PIT based on the Edmonton protocol.
We developed a novel procurement technique in cooperation with our kidney procurement team. This protocol for the procurement of pancreas and kidney from a NHBD enabled us to transplant islets into a type 1 diabetic patient and kidney into a renal failure patient.
胰岛移植（PIT）的最新进展对1型糖尿病患者的治疗有显著贡献。本研究的具体目的是开发一种从非心脏跳动供体（NHBDs）获取用于PIT的胰腺的有效技术。
2004年1月至2004年8月期间，在一个细胞处理中心获取并处理了8个人类胰腺以分离胰岛。在确认脑死亡状态后，插入双球囊导管，通过使用最初为肾脏获取而开发的原位区域器官冷却系统来防止供体胰腺发生热缺血损伤。冷却系统的导管位置针对胰腺和肾脏进行了专门修改。此外，我们与肾脏获取团队合作，在肾脏获取过程中保护胰腺。
使用改良的原位区域冷却系统可将热缺血时间控制在3.0 +/- 0.8分钟（平均值 +/- 标准误）。肾脏和胰腺的获取手术分别持续45.6 +/- 3.6分钟和10.6 +/- 1.8分钟。每次分离的胰岛产量为444,426 +/- 35,172 IE（胰岛当量）。所有8例均符合基于埃德蒙顿方案的PIT标准。
我们与肾脏获取团队合作开发了一种新的获取技术。这种从NHBD获取胰腺和肾脏的方案使我们能够将胰岛移植到1型糖尿病患者体内，并将肾脏移植到肾衰竭患者体内。
