CADAVER PANCREAS RECOVERY TECHNIQUE - IMPACT ON ISLET RECOVERY AND IN-VITRO FUNCTION

Previous studies in rodent and canine animal models have suggested a d etrimental impact on islet recovery and function when pancreas excisio n is preceded by in situ vascular flushing with cold preservation solu tions. We studied the efficacy of islet isolation from 19 consecutive cadaver pancreases procured alternately by initial pancreatectomy befo re in situ flush (group 1, our standard procurement technique, n=9) or pancreas removal following in situ vascular flushing with cold Univer sity of Wisconsin solution (group 2, n=10). Once procured, pancreases were weighed, the main pancreatic duct was cannulated, and 150 mi of c ollagenase solution was injected. The pancreases were transported to t he isolation laboratory and processed within 2 hr. Islets were counted and sized after dithizone staining, and the islet equivalents were ca lculated. Aliquots of isolated islets were cryopreserved using establi shed techniques. Islet function of both freshly isolated and frozen-th awed islets was assessed using a glucose stimulated perifusion system. Significantly more pancreas was harvested after University of Wiscons in flush (90.6+/-6.9 g for group 1 versus 66.7+/-4 for group 2, P<0.05 ). The quantity of islets per gram of processed pancreas released duri ng enzymatic digestion from each of the experimental groups did not di ffer significantly (4.5+/-0.6x10(3) islet equivalents per gram for pri mary pancreatectomy versus 4.0+/-0.4x10(3) University of Wisconsin flu sh). Similarly, following Ficoll purification, the overall yields of i slets did not differ significantly. Total islet yield in the primary p ancreatectomy group was 181+/-25x10(3) islet equivalents (2.7+/-0.3x10 (3) IE/g) versus 217+/-41x10(3) for the University of Wisconsin flush group (2.9+/-0.8x10(3) islet equivalents/g; P not significant). No dif ferences were observed in in vitro viability. Perifusion stimulation i ndexes (peak/basal insulin release) were 5.9+/-1.3 for group 1 and 7.1 +/-1.5 for group 2. These results conflict with published results in a nimal models and in dicate that large numbers of viable islets can be recovered from cadaver pancreas utilizing either procurement technique . The decreased operating time, simplicity, and safety favor the use o f total. pancreatectomy after limited in situ vascular flushing as the method of choice for pancreas procurement for subsequent islet isolat ion.