Who Says You're Too Old to Be an Organ Donor?
Miami, FL (August 27, 2002) -- About 4,500 pancreases from the scant 6,000 organ donors available each year never get used for a variety of reasons, including many organs deemed too old for transplant purposes.
But all that may soon change, if scientists at the University of Miami’s Diabetes Research Institute expand upon results of a preliminary study that uses oxygenated perflurocarbons (PFC) to, in essence, extend the upper age limit of organ donors that can be used for transplant. The study results are being presented this month at the XIX International Congress of the Transplantation Society in Miami.
“For the first time we’ve been able to show that human pancreases that would not normally be thought of as viable organs for transplant can be preserved in such a way that makes their insulin-producing cells, called islets, usable for cellular transplants,” explains Camillo Ricordi, M.D., Stacy Joy Goodman Professor of Medicine at the University of Miami and scientific director of the Diabetes Research Institute, where the innovative work was done.
“By adding PFC to traditional preservation methods we’ve been able to isolate viable islets cells from organs previously thought of as marginal for transplant purposes, and very successfully transplant those cells into patients with type 1 diabetes, freeing them from their dependence on daily shots of insulin.” Perfluorocarbons (PFC) are known for their ability to transport oxygen effectively, and have been shown to improve recovery of islet cells, which are exquisitely sensitive to oxygen deprivation, from animal pancreases.
Investigators at the DRI wanted to determine if the addition of PFC to a traditional cold preservation solution could improve organ use in a donor age group that was outside the acceptance criteria of most whole organ transplant programs.
Human pancreases, ranging in donor age from 51-64, were obtained from organ procurement organizations after they could not be allocated for whole organ transplant. Twelve consecutive human islet isolations were performed from pancreases preserved in either oxygenated solution (n = 5 with PFC) or in traditional preservation solution. (n=7 in University of Wisconsin controls).
From the PFC group, an average of 548,513 islets (IEQ) per pancreas could be isolated, while from the control group only an average of 180,740 islets (IEQ) could be isolated, a highly significant difference in yield (p< .001).
None of the islet preparations from the control group was considered suitable for transplantation, while four patients with type 1 diabetes have now been insulin independent for as long as six months with islets from organs preserved in the PFC-rich solution.
The preliminary results of this study suggest that organs previously discounted for transplantation because of donor age may in fact be a new source of hope and cells for islet transplant candidates who are currently on a waiting list. Investigators at the Diabetes Research Institute now routinely use a PFC-enriched solution during the preservation of all donor pancreases processed for islet cell transplantation, regardless of age.
Mitra Zehtab, MD, MBA