Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands.
Transplantation Center, Leiden University Medical Center, Leiden, the Netherlands.
Am J Transplant. 2021 Sep;21(9):3077-3087. doi: 10.1111/ajt.16533. Epub 2021 Mar 4.
Due to a shortage of donation after brain death (DBD) organs, donation after circulatory death (DCD) is increasingly performed. In the field of islet transplantation, there is uncertainty regarding the suitability of DCD pancreas in terms of islet yield and function after islet isolation. The aim of this study was to investigate the potential use of DCD pancreas for islet transplantation. Islet isolation procedures from 126 category 3 DCD and 258 DBD pancreas were performed in a 9-year period. Islet yield after isolation was significantly lower for DCD compared to DBD pancreas (395 515 islet equivalents [IEQ] and 480 017 IEQ, respectively; p = .003). The decrease in IEQ during 2 days of culture was not different between the two groups. Warm ischemia time was not related to DCD islet yield. In vitro insulin secretion after a glucose challenge was similar between DCD and DBD islets. After islet transplantation, DCD islet graft recipients had similar graft function (AUC C-peptide) during mixed meal tolerance tests and Igls score compared to DBD graft recipients. In conclusion, DCD islets can be considered for clinical islet transplantation.
由于脑死亡后捐献器官（DBD）的短缺，越来越多地进行循环死亡后捐献（DCD）。在胰岛移植领域，对于胰岛分离后 DCD 胰腺的胰岛产量和功能是否适宜存在不确定性。本研究旨在探讨 DCD 胰腺用于胰岛移植的潜在用途。在 9 年期间，对 126 例 3 类 DCD 和 258 例 DBD 胰腺进行了胰岛分离程序。与 DBD 胰腺相比，DCD 胰腺分离后的胰岛产量明显较低（分别为 395515 胰岛当量（IEQ）和 480017 IEQ；p=0.003）。两组之间在 2 天培养期间 IEQ 的减少没有差异。热缺血时间与 DCD 胰岛产量无关。葡萄糖刺激后的体外胰岛素分泌在 DCD 和 DBD 胰岛之间相似。胰岛移植后，与 DBD 移植物受体相比，DCD 胰岛移植物受体在混合餐耐量试验和 Igls 评分期间具有相似的移植物功能（AUC C 肽）。总之，DCD 胰岛可考虑用于临床胰岛移植。
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