Takita Morihito, Matsumoto Shinichi, Noguchi Hirofumi, Shimoda Masayuki, Chujo Daisuke, Sugimoto Koji, Itoh Takeshi, Lamont Jeffrey P, Lara Luis F, Onaca Nicholas, Naziruddin Bashoo, Klintmalm Goran B, Levy Marlon F
Baylor Research Institute, Fort Worth Campus, Fort Worth, Texas (Takita, Matsumoto, Noguchi, Sugimoto, Itoh); the Department of Internal Medicine (Shimoda), Department of Surgery (Lamont), and Division of Gastroenterology (Lara), Baylor University Medical Center at Dallas; Baylor Institute for Immunology Research, Dallas, Texas (Chujo); and Baylor Regional Transplant Institute, Dallas, Texas (Onaca, Naziruddin, Klintmalm, Levy).
Proc (Bayl Univ Med Cent). 2010 Oct;23(4):341-8. doi: 10.1080/08998280.2010.11928648.
The effectiveness of pancreatic islet isolation must be maximized to make islet cell transplantation (ICT) a standard therapy. We have performed 100 human islet isolations at Baylor Research Institute including islet isolations for research, for clinical allogeneic transplantation, and for autologous islet transplantation. In this study, we analyzed the results of these isolations. First, we assessed 79 islet isolations using brain-dead donors to determine variables associated with successful islet isolation. Univariate logistic regression analysis revealed that seven variables influenced the success of islet isolation for allogeneic ICT: cause of death, mechanism of death, techniques for pancreas procurement and preservation, heavy fatty infiltration, collagenase type, dilution time, and islet purification method. Multivariate regression analysis revealed that only the current isolation protocol, the Baylor Islet Isolation Method (BIIM)-with its four required elements of pancreas procurement by the team, pancreatic ductal injection, the two-layer method with perfluorocarbon, and density-adjusted density gradient purification-had a significant positive impact on successful islet isolation (P = 0.02). Second, we compared allogeneic and autologous ICT using the BIIM. There were no significant differences in islet yields between allogeneic and autologous ICT using the BIIM; total islet yield after purification was 628 ± 84 × 10(3) IE in allogeneic ICT vs. 576 ± 49 × 10(3) IE in autologous ICT (P = 0.59). This retrospective study revealed that the BIIM provided favorable outcomes for both autologous and allogeneic ICT.
必须最大限度地提高胰岛分离的有效性,以使胰岛细胞移植(ICT)成为一种标准疗法。我们在贝勒研究所进行了100例人类胰岛分离,包括用于研究、临床同种异体移植和自体胰岛移植的胰岛分离。在本研究中,我们分析了这些分离的结果。首先,我们评估了79例使用脑死亡供体的胰岛分离,以确定与成功胰岛分离相关的变量。单因素逻辑回归分析显示,七个变量影响同种异体ICT胰岛分离的成功:死亡原因、死亡机制、胰腺获取和保存技术、重度脂肪浸润、胶原酶类型、稀释时间和胰岛纯化方法。多因素回归分析显示,只有当前的分离方案,即贝勒胰岛分离方法(BIIM)——其具有团队进行胰腺获取、胰管注射、全氟碳双层法和密度调整密度梯度纯化这四个必需要素——对成功的胰岛分离有显著的积极影响(P = 0.02)。其次,我们使用BIIM比较了同种异体和自体ICT。使用BIIM的同种异体和自体ICT之间的胰岛产量没有显著差异;纯化后的总胰岛产量在同种异体ICT中为628±84×10³ IE,而在自体ICT中为576±49×10³ IE(P = 0.59)。这项回顾性研究表明,BIIM为自体和同种异体ICT都提供了良好的结果。