Islet transplantation: overcoming the organ shortage

Author(s)

Mantovani, Marluce da Cunha ; Gabanyi, Ilana ; Pantanali, Carlos Andres ; Santos, Vinicius Rocha ; Correa-Giannella, Maria Lucia Cardillo ; Sogayar, Mari Cleide

• Document type: Journal article
• Source: DIABETOLOGY & METABOLIC SYNDROME; v. 15, n. 1, p. 8-pg., 2023-07-01.

Abstract

Background Type 1 diabetes mellitus (T1D) is a condition resulting from autoimmune destruction of pancreatic beta cells, leading patients to require lifelong insulin therapy, which, most often, does not avoid the most common complications of this disease. Transplantation of isolated pancreatic islets from heart-beating organ donors is a promising alternative treatment for T1D, however, this approach is severely limited by the shortage of pancreata maintained under adequate conditions. Methods In order to analyze whether and how this problem could be overcome, we undertook a retrospective study from January 2007 to January 2010, evaluating the profile of brain-dead human pancreas donors offered to our Cell and Molecular Therapy NUCEL Center (www.usp.br/nucel) and the basis for organ refusal. Results During this time period, 558 pancreata were offered by the Sao Paulo State Transplantation Central, 512 of which were refused and 46 were accepted for islet isolation and 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. The data indicate that hyperglycemia, technical issues, age, positive serology and hyperamylasemia are the top five main causes for declination of a pancreas offer. Conclusions This study underlines the main reasons to decline a pancreas offer in Sao Paulo-Brazil and provides some guidance to ameliorate the rate of eligible pancreas donors, aiming at improving the islet isolation and transplantation outcome. (AU)

• FAPESP's process: 16/05311-2 - Regenerative medicine aiming at therapy for chronic degenerative diseases (cancer and diabetes)
• Grantee: Mari Cleide Sogayar
• Support Opportunities: Research Projects - Thematic Grants