Leemkuil Marjolein, Lier Grietje, Engelse Marten A, Ploeg Rutger J, de Koning Eelco J P, 't Hart Nils A, Krikke Christina, Leuvenink Henri G D
Departments of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Transplant Direct. 2018 Sep 7;4(10):e388. doi: 10.1097/TXD.0000000000000829. eCollection 2018 Oct.
Transplantation of beta cells by pancreas or islet transplantation is the treatment of choice for a selected group of patients suffering from type 1 diabetes mellitus. Pancreata are frequently not accepted for transplantation, because of the relatively high vulnerability of these organs to ischemic injury. In this study, we evaluated the effects of hypothermic machine perfusion (HMP) on the quality of human pancreas grafts.
Five pancreata derived from donation after circulatory death (DCD) and 5 from donation after brain death (DBD) donors were preserved by oxygenated HMP. Hypothermic machine perfusion was performed for 6 hours at 25 mm Hg by separate perfusion of the mesenteric superior artery and the splenic artery. Results were compared with those of 10 pancreata preserved by static cold storage.
During HMP, homogeneous perfusion of the pancreas could be achieved. Adenosine 5'-triphosphate concentration increased 6,8-fold in DCD and 2,6-fold in DBD pancreata. No signs of cellular injury, edema or formation of reactive oxygen species were observed. Islets of Langerhans with good viability and in vitro function could be isolated after HMP.
Oxygenated HMP is a feasible and safe preservation method for the human pancreas that increases tissue viability.
通过胰腺或胰岛移植来移植β细胞是一小组1型糖尿病患者的首选治疗方法。胰腺通常不被接受用于移植，因为这些器官对缺血性损伤的耐受性相对较低。在本研究中，我们评估了低温机器灌注（HMP）对人胰腺移植物质量的影响。
5个来自心脏死亡后捐赠（DCD）的胰腺和5个来自脑死亡后捐赠（DBD）的胰腺通过含氧HMP进行保存。通过分别灌注肠系膜上动脉和脾动脉，在25毫米汞柱下进行6小时的低温机器灌注。将结果与10个通过静态冷藏保存的胰腺的结果进行比较。
在HMP期间，可以实现胰腺的均匀灌注。DCD胰腺中三磷酸腺苷浓度增加了6.8倍，DBD胰腺中增加了2.6倍。未观察到细胞损伤、水肿或活性氧形成的迹象。HMP后可以分离出具有良好活力和体外功能的胰岛。
含氧HMP是一种可行且安全的人胰腺保存方法，可提高组织活力。
