Pancreas oxygen persufflation increases ATP levels as shown by nuclear magnetic resonance

W. E. Scott, B. P. Weegman, J. Ferrer-Fabrega, S. A. Stein, T. Anazawa, V. A. Kirchner, M. D. Rizzari, J. Stone, S. Matsumoto, B. E. Hammer, A. N. Balamurugan, L. S. Kidder, T. M. Suszynski, E. S. Avgoustiniatos, S. G. Stone, L. A. Tempelman, D. E R Sutherland, B. J. Hering, Klearchos K Papas

Research output: Contribution to journalArticle

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Abstract

Background: Islet transplantation is a promising treatment for type 1 diabetes. Due to a shortage of suitable human pancreata, high cost, and the large dose of islets presently required for long-term diabetes reversal; it is important to maximize viable islet yield. Traditional methods of pancreas preservation have been identified as suboptimal due to insufficient oxygenation. Enhanced oxygen delivery is a key area of improvement. In this paper, we explored improved oxygen delivery by persufflation (PSF), ie, vascular gas perfusion. Methods: Human pancreata were obtained from brain-dead donors. Porcine pancreata were procured by en bloc viscerectomy from heparinized donation after cardiac death donors and were either preserved by either two-layer method (TLM) or PSF. Following procurement, organs were transported to a 1.5-T magnetic resonance (MR) system for 31P nuclear magnetic resonance spectroscopy to investigate their bioenergetic status by measuring the ratio of adenosine triphosphate to inorganic phosphate (ATP:Pi) and for assessing PSF homogeneity by MRI. Results: Human and porcine pancreata can be effectively preserved by PSF. MRI showed that pancreatic tissue was homogeneously filled with gas. TLM can effectively raise ATP:Pi levels in rat pancreata but not in larger porcine pancreata. ATP:Pi levels were almost undetectable in porcine organs preserved with TLM. When human or porcine organs were preserved by PSF, ATP:Pi was elevated to levels similar to those observed in rat pancreata. Conclusion: The methods developed for human and porcine pancreas PSF homogeneously deliver oxygen throughout the organ. This elevates ATP levels during preservation and may improve islet isolation outcomes while enabling the use of marginal donors, thus expanding the usable donor pool.

Original languageEnglish (US)
Pages (from-to)2011-2015
Number of pages5
JournalTransplantation Proceedings
Volume42
Issue number6
DOIs
StatePublished - Jul 2010
Externally publishedYes

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Pancreas
Magnetic Resonance Spectroscopy
Adenosine Triphosphate
Oxygen
Swine
Phosphates
Gases
Islets of Langerhans Transplantation
Brain Death
Type 1 Diabetes Mellitus
Energy Metabolism
Blood Vessels
Perfusion
Costs and Cost Analysis

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Scott, W. E., Weegman, B. P., Ferrer-Fabrega, J., Stein, S. A., Anazawa, T., Kirchner, V. A., ... Papas, K. K. (2010). Pancreas oxygen persufflation increases ATP levels as shown by nuclear magnetic resonance. Transplantation Proceedings, 42(6), 2011-2015. https://doi.org/10.1016/j.transproceed.2010.05.091

Pancreas oxygen persufflation increases ATP levels as shown by nuclear magnetic resonance. / Scott, W. E.; Weegman, B. P.; Ferrer-Fabrega, J.; Stein, S. A.; Anazawa, T.; Kirchner, V. A.; Rizzari, M. D.; Stone, J.; Matsumoto, S.; Hammer, B. E.; Balamurugan, A. N.; Kidder, L. S.; Suszynski, T. M.; Avgoustiniatos, E. S.; Stone, S. G.; Tempelman, L. A.; Sutherland, D. E R; Hering, B. J.; Papas, Klearchos K.

In: Transplantation Proceedings, Vol. 42, No. 6, 07.2010, p. 2011-2015.

Research output: Contribution to journalArticle

Scott, WE, Weegman, BP, Ferrer-Fabrega, J, Stein, SA, Anazawa, T, Kirchner, VA, Rizzari, MD, Stone, J, Matsumoto, S, Hammer, BE, Balamurugan, AN, Kidder, LS, Suszynski, TM, Avgoustiniatos, ES, Stone, SG, Tempelman, LA, Sutherland, DER, Hering, BJ & Papas, KK 2010, 'Pancreas oxygen persufflation increases ATP levels as shown by nuclear magnetic resonance', Transplantation Proceedings, vol. 42, no. 6, pp. 2011-2015. https://doi.org/10.1016/j.transproceed.2010.05.091
Scott, W. E. ; Weegman, B. P. ; Ferrer-Fabrega, J. ; Stein, S. A. ; Anazawa, T. ; Kirchner, V. A. ; Rizzari, M. D. ; Stone, J. ; Matsumoto, S. ; Hammer, B. E. ; Balamurugan, A. N. ; Kidder, L. S. ; Suszynski, T. M. ; Avgoustiniatos, E. S. ; Stone, S. G. ; Tempelman, L. A. ; Sutherland, D. E R ; Hering, B. J. ; Papas, Klearchos K. / Pancreas oxygen persufflation increases ATP levels as shown by nuclear magnetic resonance. In: Transplantation Proceedings. 2010 ; Vol. 42, No. 6. pp. 2011-2015.
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AU - Scott, W. E.

AU - Weegman, B. P.

AU - Ferrer-Fabrega, J.

AU - Stein, S. A.

AU - Anazawa, T.

AU - Kirchner, V. A.

AU - Rizzari, M. D.

AU - Stone, J.

AU - Matsumoto, S.

AU - Hammer, B. E.

AU - Balamurugan, A. N.

AU - Kidder, L. S.

AU - Suszynski, T. M.

AU - Avgoustiniatos, E. S.

AU - Stone, S. G.

AU - Tempelman, L. A.

AU - Sutherland, D. E R

AU - Hering, B. J.

AU - Papas, Klearchos K

PY - 2010/7

Y1 - 2010/7

N2 - Background: Islet transplantation is a promising treatment for type 1 diabetes. Due to a shortage of suitable human pancreata, high cost, and the large dose of islets presently required for long-term diabetes reversal; it is important to maximize viable islet yield. Traditional methods of pancreas preservation have been identified as suboptimal due to insufficient oxygenation. Enhanced oxygen delivery is a key area of improvement. In this paper, we explored improved oxygen delivery by persufflation (PSF), ie, vascular gas perfusion. Methods: Human pancreata were obtained from brain-dead donors. Porcine pancreata were procured by en bloc viscerectomy from heparinized donation after cardiac death donors and were either preserved by either two-layer method (TLM) or PSF. Following procurement, organs were transported to a 1.5-T magnetic resonance (MR) system for 31P nuclear magnetic resonance spectroscopy to investigate their bioenergetic status by measuring the ratio of adenosine triphosphate to inorganic phosphate (ATP:Pi) and for assessing PSF homogeneity by MRI. Results: Human and porcine pancreata can be effectively preserved by PSF. MRI showed that pancreatic tissue was homogeneously filled with gas. TLM can effectively raise ATP:Pi levels in rat pancreata but not in larger porcine pancreata. ATP:Pi levels were almost undetectable in porcine organs preserved with TLM. When human or porcine organs were preserved by PSF, ATP:Pi was elevated to levels similar to those observed in rat pancreata. Conclusion: The methods developed for human and porcine pancreas PSF homogeneously deliver oxygen throughout the organ. This elevates ATP levels during preservation and may improve islet isolation outcomes while enabling the use of marginal donors, thus expanding the usable donor pool.

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