Abdominal normothermic regional perfusion (aNRP) is an in situ normothermic oxygenated donor perfusion technique before procurement during controlled donation after circulatory death (cDCD) procedures and allows for organ quality evaluation. There are few data on the effect of aNRP on pancreatic islet isolation and subsequent transplantation outcomes. We aim to evaluate the impact of aNRP on cDCD pancreatic islet isolation and transplantation. A retrospective analysis was performed on pancreatic islet isolation outcomes from aNRP, cDCD, and donation after brain death pancreases. Isolations were compared to previous donor age (60-75 years) matched isolations. Islet function was assessed by a dynamic glucose-stimulated insulin secretion. Donor baseline characteristics did not differ among groups. Isolations from aNRP pancreases (471 739 islet equivalents [IEQ] [655 435-244 851]) yielded more islets compared to cDCD (218 750 IEQ [375 951-112 364], P < .01) and to donation after brain death (206 522 IEQ [385 544-142 446], P = .03) pancreases. Dynamic glucose-stimulated insulin secretion tests in 7 aNRP islet preparations showed a mean stimulation index of 4.91, indicating good functionality. Bilirubin and alanine aminotransferase during aNRP correlated with islet yield (r2 = 0.685, P = .002; r2 = 0.491, P = .016, respectively). Islet isolation after aNRP in cDCD donors results in a high islet yield with viable functional islets. aNRP could increase the utilization of the pancreases for islet transplantation.

中文翻译：

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循环死亡后捐献后腹部正常热区域灌注提高胰岛分离率


腹部常温区域灌注 （aNRP） 是一种原位常温氧合供体灌注技术，在循环死亡 （cDCD） 手术后对照捐献期间，在采购前进行原位常温氧合供体灌注技术，并允许进行器官质量评估。关于 aNRP 对胰岛分离和后续移植结果影响的数据很少。我们旨在评估 aNRP 对 cDCD 胰岛分离和移植的影响。对脑死亡胰管后 aNRP 、 cDCD 和捐献的胰岛分离结果进行了回顾性分析。将分离物与先前供体年龄 （60-75 岁） 匹配的分离物进行比较。通过动态葡萄糖刺激的胰岛素分泌评估胰岛功能。供体基线特征在各组之间没有差异。与 cDCD （218 750 IEQ [375 951-112 364]，P < .01） 和脑死亡后捐献 （206 522 IEQ [385 544-142 446]，P = .03） 胰腺相比，从 aNRP 胰腺 （471 739 胰岛当量 [IEQ] [655 435-244-244 ]，P = .03） 胰腺中分离出更多的胰岛。7 种 aNRP 胰岛制剂的动态葡萄糖刺激胰岛素分泌试验显示平均刺激指数为 4.91，表明功能良好。aNRP 期间的胆红素和丙氨酸氨基转移酶与胰岛产量相关 （分别为 r2 = 0.685，P = .002;r2 = 0.491，P = .016）。在 cDCD 供体中分离 aNRP 后的胰岛可产生高胰岛产量和活的功能性胰岛。aNRP 可以提高胰岛移植对胰腺的利用率。