BACKGROUND: Europe is currently the most active region in the field of pancreatic islet transplantation, and many of the leading groups are actually achieving similar good outcomes. Further collaborative advances in the field require the standardization of islet cell product isolation processes, and this work aimed to identify differences in the human pancreatic islet isolation processes within European countries. METHODS: A web-based questionnaire about critical steps, including donor selection, pancreas processing, pancreas perfusion and digestion, islet counting and culture, islet quality evaluation, microbiological evaluation, and release criteria of the product, was completed by isolation facilities participating at the Ninth International European Pancreas and Islet Transplant Association (EPITA) Workshop on Islet-Beta Cell Replacement in Milan. RESULTS: Eleven islet isolation facilities completed the questionnaire. The facilities reported 445 and 53 islet isolations per year over the last 3 years from deceased organ donors and pancreatectomized patients, respectively. This activity resulted in 120 and 40 infusions per year in allograft and autograft recipients, respectively. Differences among facilities emerged in donor selection (age, cold ischemia time, intensive care unit length, amylase concentration), pancreas procurement, isolation procedures (brand and concentration of collagenase, additive, maximum acceptable digestion time), quality evaluation, and release criteria for transplantation (glucose-stimulated insulin secretion tests, islet numbers, and purity). Moreover, even when a high concordance about the relevance of one parameter was evident, thresholds for the acceptance were different among facilities. CONCLUSIONS: The result highlighted the presence of a heterogeneity in the islet cell product process and product release criteria.
- MeSH
- Time Factors MeSH
- Child MeSH
- Adult MeSH
- Infant MeSH
- Cells, Cultured transplantation MeSH
- Islets of Langerhans cytology MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Tissue and Organ Harvesting methods standards statistics & numerical data MeSH
- Perfusion methods statistics & numerical data MeSH
- Cell Count standards statistics & numerical data MeSH
- Child, Preschool MeSH
- Primary Cell Culture methods standards statistics & numerical data MeSH
- Surveys and Questionnaires statistics & numerical data MeSH
- Aged MeSH
- Cell Separation methods statistics & numerical data MeSH
- Practice Guidelines as Topic MeSH
- Cold Ischemia standards statistics & numerical data MeSH
- Islets of Langerhans Transplantation methods standards MeSH
- Age Factors MeSH
- Donor Selection methods standards statistics & numerical data MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Infant MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe MeSH
Variability of pancreatic donors may significantly impact the success of islet isolation. The aim of this study was to evaluate donor factors associated with isolation failure and to investigate whether immunohistology could contribute to organ selection. Donor characteristics were evaluated for both successful (n = 61) and failed (n = 98) islet isolations. Samples of donor pancreatic tissue (n = 78) were taken for immunohistochemical examination. Islet isolations with 250000 islet equivalents were considered successful. We confirmed that BMI of less than 25 kg/m(2) (P < 0.001), cold ischemia time more than 8 hours (P < 0.01), hospitalization longer than 96 hours (P < 0.05), higher catecholamine doses (P < 0.05), and edematous pancreases (P < 0.01) all unfavorably affected isolation outcome. Subsequent immunohistochemical examination of donor pancreases confirmed significant differences in insulin-positive areas (P < 0.001). ROC analyses then established that the insulin-positive area in the pancreas could be used to predict the likely success of islet isolation (P < 0.001). At the optimal cutoff point (>1.02%), sensitivity and specificity were 89% and 76%, respectively. To conclude, while the insulin-positive area, determined preislet isolation, as a single variable, is sufficient to predict isolation outcome and helps to improve the success of this procedure, its combination with the established donor scoring system might further improve organ selection.
- MeSH
- Tissue Donors statistics & numerical data MeSH
- Length of Stay statistics & numerical data MeSH
- Diabetes Mellitus, Type 1 surgery MeSH
- Edema epidemiology MeSH
- Hospitalization MeSH
- Immunohistochemistry MeSH
- Body Mass Index MeSH
- Insulin metabolism MeSH
- Islets of Langerhans metabolism surgery MeSH
- Humans MeSH
- Pancreas MeSH
- Retrospective Studies MeSH
- Cold Ischemia statistics & numerical data MeSH
- Islets of Langerhans Transplantation methods MeSH
- Vasoconstrictor Agents therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Příspěvek se zabývá problematikou přístupu studentů vysokých škol, zejména fakult Masarykovy univerzity a Mendlovy zemědělské a lesnické univerzity ke sportovně pohybovým aktivitám v rámci nepovinného předmětu Tělesná výchova. Při studiu na vysoké škole plní tělesná výchova funkci ve smyslu harmonizace tělesné a duševní složky osobnosti vedoucí ke zdraví a ke kvalitě života a přispívá k naplňování rovnováhy v každodenním životě. V pilotní studii jsme zjišťovali vztah studentů netělocvikářských oborů k tělesné výchově a k nabízeným volnočasovým aktivitám v rámci nepovinného předmětu Tělesná výchova. Představujeme některé inovační tendence, které jsou řešeny ve společném projektu.
The paper deals with a survey of the attitude of university students, especially students of faculties of the Masaryk University and the Mendel University of Agriculture and Forestry in Brno, towards sports – motor activities within the optional subject Physical Education. During university studies physical education fulfils the function of harmonisation of both physical and mental components of personality leading to health and quality of life. It contributes to fulfilling the balance in every-day life as well. In the pilot study we concentrated on the attitude of students of other than physical education study areas towards physical education in general and towards the offered leisure-time activities within the optional subject Physical Education. We present some innovative tendencies that have been worked on in a common project.
