Department of Diabetes and Metabolic Diseases Research, Beckman Research Institute of the City of Hope, Duarte, California.
Department of Diabetes and Metabolic Diseases Research, Beckman Research Institute of the City of Hope, Duarte, California
Am J Physiol Endocrinol Metab. 2015 Mar 1;308(5):E362-9. doi: 10.1152/ajpendo.00443.2014. Epub 2014 Dec 23.
Organs from hypernatremia (elevated Na+) donors when used for transplantation have had dismal outcomes. However, islet isolation from hypernatremic donors for both transplantation and research applications has not yet been investigated. A retrospective analysis of in vivo and in vitro islet function studies was performed on islets isolated from hypernatremic (serum sodium levels≥160 meq/l) and normal control (serum sodium levels≤155 meq/l) donors. Twelve isolations from 32 hypernatremic and 53 isolations from 222 normal donors were randomly transplanted into diabetic NOD Scid mice. Sodium levels upon pancreas procurement were significantly elevated in the hypernatremia group (163.5±0.6 meq/l) compared with the normal control group (145.9±0.4 meq/l) (P<0.001). The postculture islet recovery rate was significantly lower in the hypernatremia (59.1±3.8%) group compared with the normal (73.6±1.8%) group (P=0.005). The duration of hypernatremia was inversely correlated with the recovery rate (r2=0.370, P<0.001). Furthermore, the percentage of successful graft function when transplanted into diabetic NOD Scid mice was significantly lower in the hypernatremia (42%) group compared with the normal control (85%) group (P<0.001). The ability to predict islet graft function posttransplantation using donor sodium levels and duration of hypernatremia was significant (ROC analysis, P=0.022 and 0.042, respectively). In conclusion, duration of donor hypernatremia is associated with reduced islet recovery postculture. The efficacy of islets from hypernatremia donors diminished when transplanted into diabetic recipients.
高钠血症（血清钠升高）供者的器官用于移植时，其结果并不乐观。然而，尚未研究过高钠血症供者的胰岛分离用于移植和研究应用。对从高钠血症（血清钠水平≥160 meq/L）和正常对照（血清钠水平≤155 meq/L）供者中分离的胰岛进行了体内和体外胰岛功能研究的回顾性分析。将 12 次从 32 例高钠血症供者和 53 次从 222 例正常供者中分离的胰岛随机移植到糖尿病 NOD Scid 小鼠体内。高钠血症组（163.5±0.6 meq/L）的胰腺获取时的钠水平明显高于正常对照组（145.9±0.4 meq/L）（P<0.001）。高钠血症组（59.1±3.8%）的胰岛培养后回收率明显低于正常组（73.6±1.8%）（P=0.005）。高钠血症的持续时间与回收率呈负相关（r2=0.370，P<0.001）。此外，与正常对照组（85%）相比，高钠血症组（42%）移植到糖尿病 NOD Scid 小鼠后的胰岛功能成功移植率明显降低（P<0.001）。使用供体钠水平和高钠血症持续时间预测移植后胰岛移植物功能的能力具有显著意义（ROC 分析，P=0.022 和 0.042）。总之，供体高钠血症的持续时间与胰岛培养后恢复率降低有关。高钠血症供者的胰岛在移植到糖尿病受者中时效力降低。
