Hypothermic pulsatile perfusion: its use in the preservation of pancreases for 24 to 48 hours before islet cell transplantation.

Canine pancreases underwent hypothermic pulsatile perfusion for 24 or 48 hours before islet cell collagenase digestion and intrasplenic autotransplantation. The numbers of dogs surviving longer than two months are as follows: dogs receiving pancreatectomies, 0/10; dogs receiving 24-hour-perfused islet cells, 6/10, dogs receiving 48-hour-perfused islet cells, 4/10; and dogs receiving fresh islet cells, 7/10. Islet cells from 48-hour-perfused pancreases were not as good in reversing hyperglycemia as the islet cells from 24-hour-perfused pancreases. Histologically, the islet cells appeared to be normal in the fresh and 24-hour-perfused pancreases. Thus, hypothermic pulsatile perfusion of pancreas autografts for 24 hours appears to be a safe and reliable method. When this technique is used clinically, special attention should be given to 48-hour-perfused pancreases because the reversal of hyperglycemia sometime is not complete.