Agrawal Aditya, Gurusamy Kurinchi, Powis Steve, Gray Derek W, Fuller Barry, Davidson Brian R
Department of HPB and Liver Transplant Surgery, Royal Free Hospital, Royal Free and University College School of Medicine, Hampstead, London NW3 2PF, UK.
Cell Transplant. 2008;17(12):1315-22. doi: 10.3727/096368908787648065.
There are conflicting reports about the effectiveness of perfluorocarbons used in the two-layer method (TLM) of pancreas preservation for human islet transplantation. The mechanism of action is unclear and the optimal role of this method uncertain. The study design was a meta-analysis of the evidence that TLM improves islet isolation outcomes. Pubmed, CENTRAL, EMBASE, Science Citation Index, and BIOSIS were searched electronically in January 2008. After selecting the relevant human trials for meta-analysis data relating to donor variables, study design, primary and secondary islet isolation outcomes were extracted. Electronic searches identified eight unique citations, describing 11 human studies that were eligible for the meta-analysis. When comparing TLM with preservation in University of Wisconsin (UW) solution, there was a statistically significant higher islet yield [WMD 711.55, 95% confidence interval (CI) 140.03-1283.07] in the TLM group. The proportion of transplantable preparations obtained was not significantly different (OR 1.30, 95% CI 0.89-1.88) between the two groups. The rate of successful islet isolations for marginal organs was higher in the TLM group (OR 6.69, 95% CI 1.80-24.87). Improved oxygenation and preservation of cellular bioengertics is thought to be the main underlying mechanism, although no single mechanism has yet been confirmed. There is currently no clear evidence that the TLM is beneficial in human islet transplantation. It may improve the preservation of marginal organs.
关于全氟碳化合物在人类胰岛移植胰腺保存的两层法（TLM）中的有效性，存在相互矛盾的报道。其作用机制尚不清楚，该方法的最佳作用也不确定。本研究设计为对TLM改善胰岛分离结果的证据进行荟萃分析。2008年1月通过电子方式检索了PubMed、CENTRAL、EMBASE、科学引文索引和BIOSIS。在选择与供体变量、研究设计相关的荟萃分析数据的相关人体试验后，提取了主要和次要胰岛分离结果。电子检索确定了8条独特的引文，描述了11项符合荟萃分析条件的人体研究。当将TLM与威斯康星大学（UW）溶液保存进行比较时，TLM组的胰岛产量在统计学上显著更高[加权均数差（WMD）711.55，95%置信区间（CI）140.03 - 1283.07]。两组间可移植制剂的获得比例无显著差异（比值比1.30，95% CI 0.89 - 1.88）。TLM组边缘器官成功胰岛分离率更高（比值比6.69，95% CI 1.80 - 24.87）。尽管尚未确认单一机制，但改善氧合和细胞生物能量的保存被认为是主要潜在机制。目前尚无明确证据表明TLM对人类胰岛移植有益。它可能改善边缘器官的保存。
