P-179

Factors determining the acceptance of deceased donor pancreases for human islet transplantation

M. Tiwari, B. Flanagan, J. Harmon, J. Wilhelm, G. Loganathan, D. Sutherland, B. Hering, A.N. Balamurugan
Schulze Diabetes Institute, Dept. of Surgery, University of Minnesota, Minneapolis, USA

Background: Although numerous pancreases are offered to clinical islet transplantation programs, a majority of offers are rejected due to either logistical constraints or presence of critical donor factors that are known to negatively influence the islet yield or quality of islet transplants.

Methods: Data from UNOS pancreas offers for islet isolation at the University of Minnesota were gathered from January to August, 2010 (n=370), and segregated based on reasons for refusal into logistical (long cold ischemia time [CIT], cost benefit analysis of procuring a distant organ, no research consent, etc.) and donor specific reasons (age <20yrs, BMI <20, cardiac arrest >30min, creatinine >3.0mg/dl, SGOT/SGPT >300U/L, lipase >300U/l, CDC high risk, alcoholism).

Results/Discussion: Out of 370 pancreas offers, only 25 (7%) were accepted for isolation. Refusal for logistical reasons was noted in 75 (20%) cases. Refusal for donor related reasons was noted in 160 (43%) cases, of which 40 had 3 or more unacceptable parameters, 39 had 2 parameters, and 81 had 1 parameter. In 110 (30%) cases, the organ was deemed sub-optimal and was turned down because of borderline acceptable parameters and general uncertainty about the quality of the pancreas.

Conclusions: By lowering organ recovery and islet isolation costs and improving isolation techniques to increase islet yields from organs with longer CIT, lower BMI, and younger age, more organs may be processed for clinical transplant. Also, improvements in organ donor management can help to maintain organ quality and biochemical values within acceptable limits to further utilize a higher proportion of donor pancreases.

P-179

Factors determining the acceptance of deceased donor pancreases for human islet transplantation

M. Tiwari, B. Flanagan, J. Harmon, J. Wilhelm, G. Loganathan, D. Sutherland, B. Hering, A.N. Balamurugan
Schulze Diabetes Institute, Dept. of Surgery, University of Minnesota, Minneapolis, USA

Background: Although numerous pancreases are offered to clinical islet transplantation programs, a majority of offers are rejected due to either logistical constraints or presence of critical donor factors that are known to negatively influence the islet yield or quality of islet transplants.

Methods: Data from UNOS pancreas offers for islet isolation at the University of Minnesota were gathered from January to August, 2010 (n=370), and segregated based on reasons for refusal into logistical (long cold ischemia time [CIT], cost benefit analysis of procuring a distant organ, no research consent, etc.) and donor specific reasons (age <20yrs, BMI <20, cardiac arrest >30min, creatinine >3.0mg/dl, SGOT/SGPT >300U/L, lipase >300U/l, CDC high risk, alcoholism).

Results/Discussion: Out of 370 pancreas offers, only 25 (7%) were accepted for isolation. Refusal for logistical reasons was noted in 75 (20%) cases. Refusal for donor related reasons was noted in 160 (43%) cases, of which 40 had 3 or more unacceptable parameters, 39 had 2 parameters, and 81 had 1 parameter. In 110 (30%) cases, the organ was deemed sub-optimal and was turned down because of borderline acceptable parameters and general uncertainty about the quality of the pancreas.

Conclusions: By lowering organ recovery and islet isolation costs and improving isolation techniques to increase islet yields from organs with longer CIT, lower BMI, and younger age, more organs may be processed for clinical transplant. Also, improvements in organ donor management can help to maintain organ quality and biochemical values within acceptable limits to further utilize a higher proportion of donor pancreases.