Ishida-Oku M, Iwase M, Sugitani A, Masutani K, Kitada H, Tanaka M, Iida M
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Transplant Proc. 2010 Jun;42(5):1819-21. doi: 10.1016/j.transproceed.2010.02.080.
The serious shortage of brain-dead donors leads to the use of pancreata from marginal donors, including cardiac death in Japan. We studied the islet histology of pancreas graft biopsies to investigate the adequacy of using pancreata from marginal donors. Pancreas allograft biopsy was performed originally to diagnose acute rejection (Drachenberg grade I-III) at a mean of 6 months after transplantation. The percentage of beta cells showing oxidative DNA changes, replication, and apoptosis was investigated in 7 recipients of simultaneous pancreas-kidney transplantations with good graft function from marginal donors. Their causes of death were cerebrovascular with donor ages >44 years (n = 3), cardiac (n = 2), and cerebrovascular (n = 2). The percentage of beta cells per islet in the transplanted pancreas (71.9 +/- 3.3%) did not correlate with glycemic control or insulin secretion, but did correlated inversely with donor age (r = -0.81; P < .05). Oxidative DNA changes as revealed by 8-hydroxy-2'-deoxyguanosine (8-OHdG) staining were diffusely present in islet cells as well as in the exocrine cells of the transplanted pancreas. The percentage of 8-OHdG-positive cells per pancreas (71.8 +/- 4.5%) did not correlate with glycemic levels, insulin secretion, donor age, or ischemic time. There were no Ki67-positive replicating cells or terminal deoxynucleotide transferase-mediated dUTP nick-end labeling-positive apoptotic islet cells. Transplanted pancreata from marginal donors showed preserved beta cells and function despite diffuse oxidative changes.
脑死亡供体的严重短缺导致在日本使用边缘供体的胰腺，包括心脏死亡后的胰腺。我们研究了胰腺移植活检的胰岛组织学，以调查使用边缘供体胰腺的适用性。胰腺移植活检最初是为了在移植后平均6个月诊断急性排斥反应（Drachenberg I-III级）。在7例同时进行胰腺-肾脏移植且移植功能良好的边缘供体受者中，研究了显示氧化DNA变化、复制和凋亡的β细胞百分比。他们的死亡原因分别为脑血管疾病（供体年龄>44岁，n = 3）、心脏疾病（n = 2）和脑血管疾病（n = 2）。移植胰腺中每个胰岛的β细胞百分比（71.9 +/- 3.3%）与血糖控制或胰岛素分泌无关，但与供体年龄呈负相关（r = -0.81；P <.05）。8-羟基-2'-脱氧鸟苷（8-OHdG）染色显示的氧化DNA变化在移植胰腺的胰岛细胞以及外分泌细胞中均有弥漫性存在。每个胰腺中8-OHdG阳性细胞的百分比（71.8 +/- 4.5%）与血糖水平、胰岛素分泌、供体年龄或缺血时间均无关。没有Ki67阳性的复制细胞或末端脱氧核苷酸转移酶介导的dUTP缺口末端标记阳性的凋亡胰岛细胞。尽管存在弥漫性氧化变化，但边缘供体的移植胰腺仍显示出保留的β细胞和功能。
