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- Title
Pancreas preservation fluid microbial contamination is associated with poor islet isolation outcomes – a multi‐centre cohort study.
- Authors
Meier, Raphael P. H.; Andrey, Diego O.; Sun, Pamela; Niclauss, Nadja; Bédat, Benoît; Demuylder‐Mischler, Sandrine; Borot, Sophie; Benhamou, Pierre‐Yves; Wojtusciszyn, Anne; Buron, Fanny; Pernin, Nadine; Muller, Yannick D.; Bosco, Domenico; van Delden, Christian; Berney, Thierry
- Abstract
Summary: The microbiological safety of islet preparations is paramount. Preservation medium contamination is frequent, and its impact on islet yield and function remains unclear. Microbiological samples collected during islet isolations from 2006 to 2016 were analyzed and correlated to isolation and allo‐ and autotransplantation outcomes. Microbial contamination of preservation medium was found in 64.4% of processed donor pancreases (291/452). We identified 464 microorganisms including Staphylococcus (253/464, 54.5%), Streptococcus (31/464, 6.7%), and Candida species (25/464, 5.4%). Microbial contamination was associated with longer warm and cold ischemia times and lower numbers of postpurification islet equivalents, purity, transplant rate, and stimulation index (all P < 0.05). Six percent of the preparations accepted for transplantation showed microbial contamination after isolation (12/200); 9 of 12 were Candida species. Six patients were transplanted with a sample with late microbial growth discovered after the infusion. Insulin independence rate was not affected. This risk of transplanting a contaminated islets preparation was reduced by half following the implementation of an additional sampling after 24 h of islet culture. Pancreas preservation fluid microbial contamination is associated with lower transplant rate and poorer in vitro function, but not with changes in graft survival. Culture medium testing 1 day after isolation reduces the risk of incidental transplantation with contaminated islets.
- Subjects
MICROBIAL contamination; AUTOTRANSPLANTATION; TREATMENT of diabetes; TYPE 1 diabetes; MICROORGANISMS; STAPHYLOCOCCUS
- Publication
Transplant International, 2018, Vol 31, Issue 8, p917
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.13159