Hypothermic pulsatile perfusion of human pancreas: Preliminary technical feasibility study based on histology

Abstract : Background: There are currently two approaches to hypothermic preservation for most solid organs: static or dynamic. Cold storage is the main method used for static storage (SS), while hypothermic pulsatile perfusion (HPP) and other machine perfusion-based methods, such as normothermic machine perfusion and oxygen persufflation, are the methods used for dynamic preservation. HPP is currently approved for kidney trans-plantation. Methods: We evaluated, for the first time, the feasibility of HPP on 11 human pancreases contraindicated for clinical transplantation because of advanced age and/or history of severe alcoholism and/or abnormal laboratory tests. Two pancreases were used as SS controls, pancreas splitting was performed on 2 other pancreases for SS and HPP and 7 pancreases were tested for HPP. HPP preservation lasted 24 h at 25 mmHg. Resistance index was continuously monitored and pancreas and duodenum histology was evaluated every 6 h. Results: The main finding was the complete absence of edema of the pancreas and duodenum at all time-points during HPP. Insulin, glucagon and somatostatin staining was normal. Resistance index decreased during the first 12 h and remained stable thereafter. Conclusion: 24 h hypothermic pulsatile perfusion of marginal human pancreas-duodenum organs was feasible with no deleterious parenchymal effect. These observations encourage us to further develop this technique and evaluate the safety of HPP after clinical transplantation.
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Julien Branchereau, Karine Renaudin, Delphine Kervella, Stéphanie Bernadet, Georges Karam, et al.. Hypothermic pulsatile perfusion of human pancreas: Preliminary technical feasibility study based on histology. Cryobiology, Elsevier, 2018, 85, pp.56-62. ⟨10.1016/j.cryobiol.2018.10.002⟩. ⟨inserm-02157509⟩

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