Organs from donors after controlled circulatory death (
DCD III) exhibit a higher risk for graft dysfunction due to an initial period of
warm ischemia. This procurement condition can also affect the yield of beta cells in islet isolates from donor pancreases, and hence their use for
transplantation. The present study uses data collected and generated by our Beta Cell Bank to compare the number of beta cells in isolates from
DCD III (n = 141) with that from donors after
brain death (DBD, n = 609), before and after culture, and examines the influence of donor and procurement variables. Beta cell number per
DCD III-organ was significantly lower (58 x 106 versus 84 x 106 beta cells per DBD-organ; p < 0.001) but their purity (24%
insulin positive cells) and
insulin content (17 μg / 106 beta cells in
DCD III-organs versus 19 μg / 106 beta cells in DBD-organs) were similar. Beta cell number correlated negatively with duration of acirculatory
warm ischemia time above 10 min; for shorter acirculatory
warm ischemia time,
DCD III-organs did not exhibit a lower beta cell yield (74 x 106 beta cells). Use of Institut Georges Lopez-1 cold preservation
solution instead of University of Wisconsin
solution or
histidine-
tryptophan-ketoglutarate also protected against the loss in beta cell yield from
DCD III-organs (86 x 106 for IGL-1 versus 54 x 106 and 65 x 106 beta cells respectively, p = 0.042). Multivariate analysis indicates that both limitation of acirculatory
warm ischemia time and use of IGL-1 prevent the reduced beta cell yield in islet cell isolates from
DCD III-organs.