Preservation of morphology, insulin biosynthesis, and insulin release in cryopreserved human fetal pancreas.

Human fetal pancreatic glands were obtained from 12 consecutive prostaglandin-induced abortions. Explants cultured for 1 day were frozen at 0.3 degree C/min in a 1 M DMSO-containing medium and stored at -196 degrees C. After storage for 3-4 mo the frozen material was rapidly thawed and cultured 1 day before being tested for functional performance. There was a positive correlation between the pancreatic insulin content and the fetal crown-heel length. Seven of the twelve fetuses showed a marked insulin response to an acute glucose-theophylline challenge. In five of these pancreases there was a well-preserved morphology after thawing, whereas only one of the nonresponding preparations showed a satisfactory morphology. Pancreatic explants from three of four fetuses tested displayed evidences of an (pro)insulin biosynthesis. The combined results indicated that low-temperature storage of human fetal endocrine pancreas is compatible with specific functional survival.

Transplantation of fetal pancreatic microfragments via the portal vein to a diabetic patient.

Human fetal pancreas preserved in culture was used as a donor organ in a 45-yr-old man with diabetes of 14-yr duration complicated by severe retinopathy and nephropathy. Renal failure had been successfully treated by a cadaveric renal transplant 2 yr earlier. Six fetal pancreases, obtained within 30 min of delivery after prostaglandin-induced abortion at 14--20 wk of gestation, were minced and placed in tissue culture for 3 h at the earliest and 15 days at the longest duration. The cultures were harvested 2--3 h before transplantation. Approximately 3 ml of tissue was infused into a right portal vein branch. Azathioprine was continued at 2 mg/kg and prednisolone increased from 10 mg to 100 mg/day on the day of transplantation and gradually reduced to 25 mg/day. Only two doses of antilymphocytic globulin were given because of a severe reaction. During the 40 days since transplantation, insulin requirements have not changed, but C-peptide has appeared in the urine, suggesting function of the transplanted tissue.

A technique for rapid harvesting of cadaveric renal and pancreatic grafts after circulatory arrest.

In several countries, organs for transplantation cannot be removed from cadaver donors until cardiac arrest has occurred. A technique is described for removal of the kidneys and pancreas in which the whole abdominal contents are freed and reflected so that the retroperitoneal organs lie uppermost. The aorta is opened longitudinally and the relevant arteries are cannulated via their orifices. Cold perfusion of the three organs can usually be initiated 5-15 minutes after cardiac arrest and significant ischaemia is avoided. The full length of the vascular pedicles can be preserved and the dissection of the retroperitoneal organs is greatly facilitated.

A technique for rapid harvesting of cadaveric renal and pancreatic grafts after circulatory arrest.

In Sweden, organs for transplantation can not be removed from cadaver donors until cardiac arrest has occured. We describe a technique for removal of kidneys and pancreas in which the whole abdominal contents are freed and reflected so that the retroperitoneal organ lie uppermost. The aorta is opened longitudinally and the relevant arteries are cannulated via the orifices. Cold perfusion of the three organs can usually be initiated 5-15 min after cardiac arrest and significant ischaemia is avoided. The full length of the vascular pedicles can be preserved and the dissection of the retroperitoneal organs is greatly facilitated.