Noguchi Hirofumi, Ueda Michiko, Hayashi Shuji, Kobayashi Naoya, Okitsu Teru, Iwanaga Yasuhiro, Nagata Hideo, Nakai Yusuke, Matsumoto Shinichi
Transplantation Unit, Kyoto University Hospital, Kyoto 606-8507, Japan.
Cell Transplant. 2008;17(1-2):69-81. doi: 10.3727/000000008783907062.
For islet transplantation, it is important to obtain an available islet mass adequate for diabetes reversal from a single donor pancreas. A recent report demonstrated that the use of M-Kyoto solution instead of UW solution improved islet yields in the two-layer method for pancreas preservation. The present study investigated whether the ductal injection of a large volume of preservation solution (UW and M-Kyoto solution) before pancreas storage improves islet yields. Islet yield both before and after purification was significantly higher in the ductal injection (+) group compared with the ductal injection (-) group. TUNEL-positive cells in the ductal injection (+) group were significantly decreased in comparison to the ductal injection (-) group. The ductal injection of preservation solution increased the ATP level in the pancreas tissue and reduced trypsin activity during the digestion step. Annexin V and PI assays showed that the ductal injection prevents islet apoptosis. In a transplant model, the ductal injection improved islet graft function. These findings suggest that the ductal injection of preservation solution, especially the M-Kyoto solution, leads to improved outcomes for pancreatic islet transplantation. Based on these data, this technique is now used for clinical islet transplantation from non-heart-beating donor pancreata or living donor pancreas.
对于胰岛移植而言,从单个供体胰腺获取足以逆转糖尿病的可用胰岛量至关重要。最近一份报告表明,在双层胰腺保存方法中,使用M - 京都溶液而非UW溶液可提高胰岛产量。本研究调查了在胰腺储存前通过导管注入大量保存溶液(UW溶液和M - 京都溶液)是否能提高胰岛产量。与导管注射(-)组相比,导管注射(+)组纯化前后的胰岛产量均显著更高。与导管注射(-)组相比,导管注射(+)组中TUNEL阳性细胞显著减少。导管注射保存溶液可提高胰腺组织中的ATP水平,并在消化步骤中降低胰蛋白酶活性。膜联蛋白V和碘化丙啶检测表明,导管注射可防止胰岛凋亡。在移植模型中,导管注射改善了胰岛移植功能。这些发现表明,导管注射保存溶液,尤其是M - 京都溶液,可改善胰岛移植的结果。基于这些数据,该技术目前用于非心跳供体胰腺或活体供体胰腺的临床胰岛移植。