Functional islets and where to find them

Abstract

This thesis explores methods and strategies to most optimally isolate viable, functional pancreatic islets from donor pancreases. After analyzing the current challenges within the field, the manuscript examines the applicability of donation after circulatory death pancreases for islet isolation. The results of these isolations are discussed in the next chapter. A novel strategy to judge suitability of all donor pancreases is presented hereafter. The Islet Isolation Outcome Prediction Score is a multifactorial donor risk index in predicting obtained islet equivalents after isolation. After an organ is allocated and accepted, it must be preserved before it arrives at the isolation facility. To optimize this process, the use of hypothermic machine perfusion is explored in a feasibility study. Next, a novel islet isolation technique, the PancReatic Islet Separation Method is presented. This method can vastly improve isolation duration, efficiency, and standardization. Lastly, the results of the thesis are discussed.