61 - Freie Mitteilung
HPB II & general oncology
16. Mai 2019, 13:45 - 15:15, Bellavista 5, 6. OG
Impact of ischemia time on islet isolation success and post-transplantation clinical outcomes: A retrospective study on 452 pancreas isolations
C. Wassmer1, G. Parnaud1, K. Bellofatto1, F. Lebreton1, E. Brioudes1, L. Perez1, N. Pernin1, C. Rouget1, D. Matthey-Doret1, J. Loureiro1, C. Bosson1, P. Benhamou2, L. Kessler3, L. Badet4, E. Berishvili1, D. Bosco1, T. Berney1, V. Lavallard1, Presenter: C. Wassmer1 (1Geneva, 2Grenoble/FR, 3Strasbourg/FR, 4Lyon/FR)
Many variables can affect the islet isolation process including ischemia time (IT) of the pancreas before the initiation of the isolation procedure. The maximum IT to be kept in order to avoid a negative impact on the isolation process is not well defined. In our laboratory, a total ischemia time (TIT) of <8hours is considered optimal and TIT between 8 and 12 hours is acceptable but considered suboptimal. We investigated the impact of IT on isolation success and post-transplantation clinical outcome.
A retrospective analysis of all islet isolations performed in our center between 2008 and 2018 was done. Cold ischemia time (CIT), organ removal time (ORT) and TIT (CIT + ORT) were analyzed. Variables related to donors and organ procurement in successful and failed islet isolations and clinical outcome after transplantation were evaluated. A cut off of 8 hours for the CIT and TIT was defined based on our actual knowledge and a cut off of 60 minutes was defined for ORT.
452 pancreata met the inclusion criteria. 218 pancreata were successfully isolated and transplanted. No difference was founded in term of number of grafted islet preparations, number of islet equivalent (IEQ), viability and islets function between the >8 hours group and the < 8 hours group. Donor characteristics such as age, gender, BMI and pancreas weight were compared and no difference between the two groups was observed. Recipient pre and post-transplantation HbA1c, C-peptide values and insulin requirement were compared between the two groups and no statistic difference was founded. The same observation could be made for CIT and ORT as well as for a cut off pushed until 12 hours of CIT and TIT.
This study showed no difference in term of islet isolation success and post-transplantation clinical outcome between groups with <8 hours of TIT and >8 hours. Ischemia time should always be as short as possible but cut off for TIT can be pushed until 12 hours. This must be taken into consideration when IT during organ procurement may become a limiting factor for pancreatic removal.