Clinical application of the two-layer (University of Wisconsin solution/perfluorochemical plus O-2) method of pancreas preservation before transplantation

Background. The two-layer method [University of Wisconson solution (UW)/per fluorochemical plus O-2] for pancreas preservation has been demonstrated to be superior to simple UW storage alone in the canine model. For the first time, we applied the two-layer method to clinical whole-pancreas transplant ation. Methods. Pancreases were placed in the two-layer method in 10 cases and UW alone in 44 cases before transplant. The mean cold ischemic time was 16.5 h r in the two-layer group versus 18.1 hr in the UW group (P=NS), We compared the condition of graft at the time of reperfusion, and then 3 months postt ransplant graft function and complications. Results. At the time of reperfusion, no grafts in the two-layer group were edematous, compared with 10(23.3%) of 43 in the UW group (P=0.18), Seven (7 0%) of 10 grafts in the two-layer group obtained the best overall quality s core, compared with 24(57.1%) of 42 in the UW group (P=0.72). Nine (90%) of 10 recipients in the two layer group became insulin-independent during hos pitalization, compared with 31(70.5%) of 44 in the UW group (P=0.26). Time to insulin independence was no different between the two groups. No pancrea s grafts preserved by the two-layer method suffered acute rejection. Conclusions. The two-layer preservation method is feasible in human clinica l transplantation. It was at least equivalent and may be superior to UW alo ne in both morphologic and functional assessment of the transplanted pancre as.