Role of pancreas machine perfusion to increase the donor pool for beta cell replacement

As a result of donor shortage pressure, an increased number of extended criteria donors (ECD) are currently used for transplantation. For example, donation after brain death donors (DBD) of higher age and BMI, or donation after circulatory death donors (DCD). Furthermore, due to this increasing scarcity of pancreases with optimal donor characteristics, islet isolation centres utilise pancreases from ECD, which are particularly susceptible to prolonged cold ischemia time.

The advent of hypothermic and normothermic Machine Perfusion (MP), as forms of preservation deemed superior to cold storage for high-risk  kidney and liver donor organs, have created opportunities in the field of the pancreas surgery.

The discussion concerns whether such techniques, when applied to the pancreas, can increase the pool of suitable donor organs for both pancreas and islet transplantation. Recent experimental models of porcine and human ex-vivo pancreatic MP appear promising. Applications of MP to the pancreas, however, need refinement, such as perfusion protocols and viability assessment tools.

In summary, a consensus report is now necessary regarding the role of pancreas machine perfusion with a view to increasing the donor pool for beta cell replacement.

Topic Chairs: Joana Ferrer

Topic Steering Committee: Julien Branchereau, Marten A Engelse, Trevor Reichman, Vassilios Papalois, Cinthia Drachenberg, Fabio Vistoli, Steve White, Paul Johnson, Henri G. D. Leuvenink, Benoît Mesnard, Ann Etohan Ogbemudia, Franka Messner, Jason Doppenberg