P-222

Islet transplantation: overcoming the organ shortage

M. Mantovani, I. Gabany, L. Labriola, T.R. Mares-Guia, L.H. Lojudice, M.C. Sogayar
University of Sao Paulo, Biochemistry, São Paulo, Brazil

Type 1 Diabetes mellitus (T1DM) is a condition resulting from the autoimmune destruction of pancreatic beta cells, with most diabetic patients requiring lifelong insulin therapy, but, often insulin therapy does not avoid the most common complications of Diabetes. In some cases, transplantation of isolated pancreatic islets from heart-beating organ donors is a promising possibility for optimal treatment of T1DM, however, this approach is severely limited by the shortage of pancreata displaying adequate conditions, among other reasons.

Objective: To analyze whether and how this organ shortage problem could be overcome.

Methods: We evaluated the characteristics profile of brain-dead human pancreas donors and, also, the basis for organ refusal. 562 pancreata were offered by the State of São Paulo Transplantation Central from January 2007 to January 2010, from which 512 were refused and 56 were accepted by the University of São Paulo Islet Unit for islet isolation, purification, characterization and, eventually, transplantation. Due to the elevated number of refused organs, we decided to analyze the main reasons for refusal in order to evaluate the possibility of improving the organ acceptance rate.

Results: Our data show that hyperglycemia, technical issues, age, serology and hyperamylasemia are the top five main causes for declination of pancreas offer.

Conclusions: This study evidences the main reasons to decline a pancreas offer and provide some guidance to ameliorate the rate of eligible pancreas donors, aiming at improving the islet transplantation outcome.

Key words: Organ donation,diabetes mellitus, pancreas, islet transplantation , donors´ profile.

Supportedby: FINEP, FAPESP, CNPq, MS-DECIT,MCT, BNDES.

P-222

Islet transplantation: overcoming the organ shortage

M. Mantovani, I. Gabany, L. Labriola, T.R. Mares-Guia, L.H. Lojudice, M.C. Sogayar
University of Sao Paulo, Biochemistry, São Paulo, Brazil

Type 1 Diabetes mellitus (T1DM) is a condition resulting from the autoimmune destruction of pancreatic beta cells, with most diabetic patients requiring lifelong insulin therapy, but, often insulin therapy does not avoid the most common complications of Diabetes. In some cases, transplantation of isolated pancreatic islets from heart-beating organ donors is a promising possibility for optimal treatment of T1DM, however, this approach is severely limited by the shortage of pancreata displaying adequate conditions, among other reasons.

Objective: To analyze whether and how this organ shortage problem could be overcome.

Methods: We evaluated the characteristics profile of brain-dead human pancreas donors and, also, the basis for organ refusal. 562 pancreata were offered by the State of São Paulo Transplantation Central from January 2007 to January 2010, from which 512 were refused and 56 were accepted by the University of São Paulo Islet Unit for islet isolation, purification, characterization and, eventually, transplantation. Due to the elevated number of refused organs, we decided to analyze the main reasons for refusal in order to evaluate the possibility of improving the organ acceptance rate.

Results: Our data show that hyperglycemia, technical issues, age, serology and hyperamylasemia are the top five main causes for declination of pancreas offer.

Conclusions: This study evidences the main reasons to decline a pancreas offer and provide some guidance to ameliorate the rate of eligible pancreas donors, aiming at improving the islet transplantation outcome.

Key words: Organ donation,diabetes mellitus, pancreas, islet transplantation , donors´ profile.

Supportedby: FINEP, FAPESP, CNPq, MS-DECIT,MCT, BNDES.