Objective Donors after controlled circulatory death (DCD-III) are considered a valuable source of organs to expand the donor pool but the longer period of warm ischemia times (WIT) appears associated with more graft dysfunction and post-transplant complications than for donors after brain death (DBD). The present study compares outcome of pancreatic islet cell isolation from DCD-III with that from DBD. Methods The data base of our Beta Cell Bank was used to conduct a retrospective analysis of donor and procurement characteristics and associated quality control data of pancreatic isolates for the period 2007-2018. This included 614 DBD and 142 DCD-III organs. Results The beta cell yield isolated from DCD-III organs was significantly lower than that from DBD, both on the day of isolation (77±6.4x106 vs 103±3.2x106 beta cells; p<0.01) and after 2 days of culture (41±3.3x106 vs 64±2.3x106 beta cells; p<0.01). DCD-III were also associated to a lower clinical utility rate for transplantation (34% vs 42%), mainly because of insufficient beta cell number. In DCD-III, this number was negatively correlated to the duration of acirculatory WIT (p<0.05 and p<0.05); total WIT (p=0.06 and p<0.05), procurement time (p=0.10 and p<0.05) and cold ischemia time (CIT)(p=NS and p<0.05). When these parameters are restricted to values corresponding to priority procurement and preservation (acirculatory WIT<15min, total WIT<30min, procurement time<60min, CIT<8h), no significant differences in beta cell yield was observed between DCD-III and DBD organs (. Conclusion DCD-III pancreases can be used for the preparation of islet cell grafts but the warm ischemia time reduces the yield in isolated beta cells and thus the risk that the number is insufficient for clinical use. Duration of expected warm and cold ischemia times help decide to accept a pancreas for islet isolation. Determination of beta cell number on the day of isolation and after a first culture period helps decide whether or not to continue preparation for a clinical implant. DCD-III remain a valuable source of donor organs for islet cell preparation when procured and preserved under priority conditions.
Original languageEnglish
Publication statusPublished - 14 Mar 2019
EventBelgian Transplantation Society - Antwerp, Belgium
Duration: 14 Mar 201914 Mar 2019

Conference

ConferenceBelgian Transplantation Society
CountryBelgium
CityAntwerp
Period14/03/1914/03/19

ID: 44996159