Human Islets Derived From Donors After Cardiac Death Are Fully Biofunctional

• Published in: American journal of transplantation Vol. 7; no. 10; pp. 2318 - 2325
• Main Authors: Zhao, M., Muiesan, P., Amiel, S. A., Srinivasan, P., Asare‐Anane, H., Fairbanks, L., Persaud, S., Jones, P., Jones, J., Ashraf, S., Littlejohn, W., Rela, M., Heaton, N., Huang, G. C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-10-2007
• Subjects: Adolescent; Adult; BDD; Cell Survival; Cytokines - blood; Death, Sudden, Cardiac - pathology; diabetes; Diabetes Mellitus, Type 1 - surgery; Female; Humans; islet transplantation; islets isolation; Islets of Langerhans - physiology; Islets of Langerhans Transplantation - pathology; Islets of Langerhans Transplantation - physiology; Male; Middle Aged; NHBD; Organ Size; Pancreas - anatomy & histology; Tissue Donors
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2007.01937.x

Islets from brain‐dead donors (BDDs) are being used in the treatment of Type 1 diabetes. However, both donor numbers and islet survival are limited. We explored the clinical potential for islets from non‐heart‐beating donors (NHBDs), who have lower circulating cytokines, by comparing islets from 10 NHBDs against 12 identically‐isolated islets from BDDs over the same time period. The quantity and quality of islets from NHBDs was good. NHBD yielded ∼12.6% more islets than those of BDDs (505 000 ± 84 230 vs. 400 970 ± 172 430 islet equivalent number [IEQ]/pancreas, p = 0.01) with comparable viability. ATP and GTP contents were lower (6.026 ± 3.076 vs. 18.105 ± 7.8 nM/mg protein, p = 0.01 and 1.52 ± 0.87 vs. 3.378 ± 0.83 nM/mg protein, p = 0.04) and correlated negatively to warm ischemia time (R2= 0.8022 and R2= 0.7996, respectively). Islets from NHBDs took longer to control hyperglycemia in diabetic mice, but were equally able to sustain euglycemia. With a warm ischemia time (WIT) of ≤25 min, islets from NHBDs are at least as competent as islets from BDDs and should be suitable for clinical use.
Islets from organs donated after death are additional sources suitable for human islet transplantation.