Defining Islet Isolation Success of Chronic Pancreatitis Pancreas & Brain-Dead Donor Pancreas Intended for Auto & Allo-Transplantation

Thursday, April 11th, 2024 | 11 AM ET

Presented by
Balamurugan N. Appakalai, PhD, Nationwide Children’s Hospital

Recovery of human islets from pancreata recovered from brain-dead donors and chronic pancreatitis patients for subsequent transplantation requires consideration of different factors. For islet allo-transplant, the donor characteristics and techniques used during pancreas removal and islet isolation affect the success of islet isolation. Isolating islets from pancreata from donors with a high BMI has a higher probability of success than isolating islets from donors with a low BMI. The choice of neutral protease and control of the ratio of collagenase/protease activities is critical since it affects the percentages of free and embedded islets.

By contrast, pancreata recovered from chronic pancreatitis patients have different degrees of damage and fibrosis depending on the course of the patient’s disease. The islet isolation procedures used for organ donors are usually modified before and often during the islet isolation procedure. This includes changing the collagenase/protease activity ratios, performing intraparenchymal injection of the enzyme solution, or extending the digestion time.

For either isolation procedure, the most critical factors to control are the pancreas procurement technique, the cold ischemia time, and the choice of enzymes used for tissue digestion.

About the Presenter

Balamurugan N. Appakalai, PhD
Nationwide Children’s Hospital

Dr. Balamurugan has extensive experience in processing pancreases for auto- and allo-clinical islet transplantation and xeno-transplantation. As an “isletologist” for the past 27 years, his research focused on improving the manufacture of pancreatic islet products for clinical transplantation. His contributions showing the impact of the dose of different enzyme formulations on islet yields provided new insights that will likely improve human islet yield and function. Recently, he also has working to improve islet microcirculation by stimulating intra-islet endothelial cells and studying the cross talk between endothelial cells and beta cells. He has published more than 200 research articles, including book chapters, and serves on several journal editorial review boards.