Zeng Y, Torre M A, Karrison T, Thistlethwaite J R
Department of Surgery, University of Chicago, Illinois 60637.
Transplantation. 1994 Mar 27;57(6):954-8. doi: 10.1097/00007890-199403270-00031.
Clinical islet allotransplantation is dependent on the ability to achieve a high yield and purity of islets isolated from human cadaver pancreas donors. The aim of this study was to determine the factors influencing the pancreas prior to islet isolation that may alter yield and purity. The results of 50 consecutive islet isolations from cadaver donor human pancreati at the University of Chicago Medical Center from December 1991 to April 1993 were analyzed. All pancreati were first offered for whole pancreas transplantation before being considered for islet isolation. Human pancreatic islet isolation was accomplished by a modified automated method. Some islet isolations resulted in a high islet yield but low islet purity. Other resulted in well-purified islets, but a low yield. Arbitrarily, successful islet isolation is defined as that yielding over 250,000 islet equivalents (EQN) with a purity of at least 80%. The success rate of human pancreatic islet isolation was 70%. The mean final islet yield obtained from these 50 pancreati was 300,000 +/- 131,000 islet EQN. The mean purity of the final preparation was 73% +/- 25%. By univariate analysis, five factors were found to affect significantly the yield, purity, or overall success rate of islet isolation: organ cold ischemic time, donor age, donor plasma glucose levels, donor body weight, and cause of donor death. Even when islet isolation was successful, the function of islets from hyperglycemic and older donors appear to be impaired both in vitro and in vivo. These results suggest that islet yield and purity are affected by multiple donor-related factors. Even when adequate yield and purity are obtained, islet function is also dependent on donor variables.
临床胰岛同种异体移植依赖于从人类尸体胰腺供体中获取高产率和高纯度胰岛的能力。本研究的目的是确定在胰岛分离之前影响胰腺的因素，这些因素可能会改变产量和纯度。分析了1991年12月至1993年4月在芝加哥大学医学中心对50例尸体供体人类胰腺进行连续胰岛分离的结果。所有胰腺在考虑用于胰岛分离之前首先被提供用于全胰腺移植。人类胰岛分离通过改良的自动化方法完成。一些胰岛分离导致胰岛产量高但纯度低。其他的则导致胰岛纯度高，但产量低。任意地，成功的胰岛分离被定义为产生超过250,000个胰岛当量（EQN）且纯度至少为80%。人类胰岛分离的成功率为70%。从这50个胰腺中获得的最终胰岛平均产量为300,000 +/- 131,000个胰岛EQN。最终制剂的平均纯度为73% +/- 25%。通过单因素分析，发现有五个因素显著影响胰岛分离的产量、纯度或总体成功率：器官冷缺血时间、供体年龄、供体血浆葡萄糖水平、供体体重和供体死亡原因。即使胰岛分离成功，来自高血糖和老年供体的胰岛在体外和体内的功能似乎也受到损害。这些结果表明，胰岛产量和纯度受多种与供体相关的因素影响。即使获得了足够的产量和纯度，胰岛功能也还取决于供体变量。
