Utility of islet cell preparations from donor pancreases after euthanasia

Patients fulfilling criteria for euthanasia can choose to donate their organs after circulatory death (DCD V). This study assesses the outcome of islet cell isolation from DCD V pancreases. A procedure for DCD V-procurement provided 13 pancreases preserved in Institut Georges Lopez-1 preservation solution and following acirculatory warm ischemia time under 10 minutes. Islet cell isolation outcomes are compared to those from reference donor organs after brain death (DBD, n = 234), and a cohort of donors after circulatory death (DCD III, n = 29) procured under the same conditions. Islet cell isolation from DCD V organs resulted in better in vitro outcome than for selected DCD III or reference DBD organs. A 50% higher average beta cell number before and after culture and a higher average beta cell purity (35% versus 24% and 25%) was observed, which led to more frequent selection for our clinical protocol (77% of isolates versus 50%). The functional capacity of a DCD V islet cell preparation was illustrated by its in vivo effect following intraportal transplantation in a type 1 diabetes patient: injection of 2 million beta cells/kg body weight (1900 IEQ/kg body weight) at 39% insulin purity resulted in an implant with functional beta cell mass that represented 30% of that in non-diabetic controls.
In conclusion, this study describes procurement and preservation conditions for donor organs after euthanasia which allow preparation of cultured islet cells, that more frequently meet criteria for clinical use than those from DBD or DCD III organs.

Publication year:2022

Keywords:islet transplantation, organ donation after circulatory death, organ donation after euthanasia, organ donation after medical assistance in dying

Accessibility:Open