Li Xiaohang, Zhang Jialin, Sang Lixuan, Chu Zhiqiang, Dong Ming
1 Department of General Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning Province - China.
Int J Artif Organs. 2015 Mar;38(3):117-25. doi: 10.5301/ijao.5000391. Epub 2015 Mar 17.
There has been continuous debate on whether the Two-Layer Method (TLM) is superior to the University of Wisconsin solution (UW) for preserving human pancreas prior to islet isolation. The objective of the current meta-analysis is to assess which method is superior.
We searched electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) for relevant human trials published in the English language from January 2000 to October 2013. Data on donor characteristics and islet isolation outcomes were extracted.
14 articles containing 18 human studies were included in this meta-analysis. In comparison to UW alone, TLM alone produced a significantly higher islet yield (weighted mean difference, 776.32; 95% confidence interval; 370.82-1181.82; P = .0002). TLM alone also yielded higher proportion of transplantable preparations (odds ratio, 1.60; 95% confidence interval; 1.15-2.23; P = .005). The following measures did not differ: islet viability (weighted mean difference, 2.10; -2.41-6.60; P = .360), purity (weighted mean difference, -0.92; -3.75-1.91; P = .520) and function assessed by measuring the stimulation index (weighted mean difference, 0.17; -0.21-0.55; P = .380). When comparing TLM following UW storage with UW alone, the results were similar to the previous ones.
This data indicates that the TLM can improve islet yield and increase the opportunities of human pancreatic islet transplantation. Therefore, the TLM should be recommended for preserving human pancreas prior to islet isolation.
关于在胰岛分离前保存人类胰腺时，双层法（TLM）是否优于威斯康星大学溶液（UW）一直存在持续的争论。当前荟萃分析的目的是评估哪种方法更优。
我们检索了电子数据库（MEDLINE、EMBASE、Cochrane对照试验中心注册库），以查找2000年1月至2013年10月以英文发表的相关人体试验。提取了供体特征和胰岛分离结果的数据。
本荟萃分析纳入了14篇包含18项人体研究的文章。与单独使用UW相比，单独使用TLM产生的胰岛产量显著更高（加权平均差，776.32；95%置信区间；370.82 - 1181.82；P = 0.0002）。单独使用TLM还产生了更高比例的可移植制剂（优势比，1.60；95%置信区间；1.15 - 2.23；P = 0.005）。以下指标没有差异：胰岛活力（加权平均差，2.10； - 2.41 - 6.60；P = 0.360）、纯度（加权平均差， - 0.92； - 3.75 - 1.91；P = 0.520）以及通过测量刺激指数评估的功能（加权平均差，0.17； - 0.21 - 0.55；P = 0.380）。当将UW保存后的TLM与单独使用UW进行比较时，结果与之前的相似。
这些数据表明，TLM可以提高胰岛产量并增加人类胰岛移植的机会。因此，在胰岛分离前保存人类胰腺时，应推荐使用TLM。
