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Normothermic Ex Vivo Perfusion of Discarded Human Pancreases: A Feasibility Study to Expand the Pancreas Donor Pool

C. Parmentier, S. Ray, L. Mazilescu, M. Kawamura, Y. Noguchi, T. Goto, B. Arulratnam, S. Ganesh, M. Selzner, T. Reichman

UHN - Toronto General Hospital, Toronto, ON, Canada

Meeting: 2022 American Transplant Congress

Abstract number: 941

Keywords: Donation, Machine preservation, Pancreas, Pancreas transplantation

Topic: Basic Science » Basic Science » 15 - Machine Perfusion and Organ Rehabililtation - Basic

Session Information

Session Name: Machine Perfusion and Organ Rehabilitation - Basic

Session Type: Poster Abstract

Date: Sunday, June 5, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Normothermic Ex Vivo Perfusion (NEVPP) model has been used in the clinical setting for Lung, heart, liver, and kidney. However, a system for human pancreas perfusion has not been successfully established to date. The purpose of this study was to perfuse discarded human pancreases with a novel system previously established for porcine pancreases in order to assess feasibility and optimal parameters.

*Methods: Four discarded human pancreases from brain dead donors were perfused during 4 hours in our normothermic ex vivo system with parameters previously established in a successful porcine model. Samples of the perfusate were taken before the start of perfusion, immediately after the start of perfusion, and then at hour intervals, and tested for amylase, insulin, C-peptide, glucose, lactate, and blood gas analysis (arterial and venous). Biopsies of the graft were also taken before the start of perfusion, at 1 hour after the initiation of the perfusion and at the end of the perfusion.

*Results: Average graft weight before preservation was 371 g ±128 g, graft weight after preservation was 499.5 g ±119 g with an average increase of 39.5% ±18.6%. Glucose and lactate levels decreased during perfusion in all cases (Figure 1). Insulin levels increased progressively throughout the perfusion (Figure 2). The oxygen extraction ratio in cases 1 and 3 were above the normal range (20-30%) and for cases 2 and 4, were close to normal. Histologically, the pancreatic graft biopsies obtained after 4 hours of perfusion showed preservation of pancreatic acini and islet cells with little to no evidence of tissue injury.

*Conclusions: Human pancreas perfusion appears feasible and grafts can be perfused without significant tissue injury. Future work will focus on definitive biochemical parameters to assess the quality of pancreas during normothermic perfusion. With further studies, NEVPP will hopefully aid in expanding the donor pool.

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To cite this abstract in AMA style:

Parmentier C, Ray S, Mazilescu L, Kawamura M, Noguchi Y, Goto T, Arulratnam B, Ganesh S, Selzner M, Reichman T. Normothermic Ex Vivo Perfusion of Discarded Human Pancreases: A Feasibility Study to Expand the Pancreas Donor Pool [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/normothermic-ex-vivo-perfusion-of-discarded-human-pancreases-a-feasibility-study-to-expand-the-pancreas-donor-pool/. Accessed May 9, 2025.

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