Summary
Despite improvements in islet isolation techniques, islet transplantation remains
unpredictable as a method for reliably rendering human type I diabetic recipients
normoglycemic. Advances in immunosuppression to prevent primary nonfunction, to promote
engraftment and to prevent rejection should improve success rates. However, factors
influencing the isolation process remain incompletely defined. During our experience,
the donor's nutritional status as well as other donor characteristics were noted to
be associated with islet isolation success. Thus, in this study, we tried to clarify
whether the body mass index of the human pancreatic donor affects islet isolation
yield and viability. In lean donors we found significantly lower islet yields in comparison
with normal and obese donors and a significantly lower islet viability compared to
obese donors. Obese donor islets had a significantly higher insulin secretory capacity
than lean and normal donor islets. In summary, islet yield and viability were improved
selecting pancreata from obese donors associated with a BMI > 24 for islet preparation.
We hypothesize that, on the one hand, the increased distribution of fat in pancreata
of obese donors possibly can facilitate the release of islets during the collagenase
digestion, and, on the other hand, pancreata of obese donors contain more islets than
pancreata of lean donors. These data underline the decisive influence of the pancreas
donor's body mass index on successful human islet isolation. The body mass index should
be noted as a potential predictor of success of islet preparations.
Key words
Human islet isolation - pancreas donor - donor data - body mass index
