Predicting the outcome of human islet isolation

• Background. Islet transplantation is currently being explored as a possible treatment to diabetes mellitus. Islet isolation from the human pancreas is a technically demanding process and the success rate even in the most experienced GMP facilities is only about 50%. The aim of this study was to investigate whether isolation outcome can be predicted from a pancreas biopsy taken during organ procurement. Methods. The outcome of 29 human islet isolations was retrospectively studied. Biopsies from the pancreatic head were immunostained for insulin to study islet morphology and size distribution utilizing a digital analysis system. Isolations were categorized as successful if they yielded more than 2000 IE/g.  Results. Pellet volume after collagenase digestion and islet purity was higher in the successful group. None of the morphology variables, i.e. islet number (IN/mm2), islet equivalent number (IE/IN) and percentage of insulin positive area in the biopsy, differed significantly between the study groups. Conclusions. No single morphological feature observed in a biopsy taken from the head of pancreas can predict the outcome of islet isolation from the human pancreas, even if using the same enzyme blend in standardized human islet isolation procedure.

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