The influence of preoperative donor factors on the performance of the isolated perfused human pancreas.

The present study was undertaken to determine whether there exist specific donor factors which influence the performance of the isolated perfused human pancreas with respect to the sustained level of insulin secretion. Donor factors included age, serum glucose, hospital days, CMV status, RBC transfusion history, and smoking history. Following pancreas procurement, single-pass perfusion was performed in pancreata obtained from 35 cadaveric organ donors using a modified Krebs buffer. Aliquots were collected every 2 min and assayed for insulin concentration. Data was analyzed for 120 min for each pancreas. The mean initial insulin concentration was 2989 +/- 383 microU/ml and the insulin concentration at 120 min averaged 1467 +/- 338 microU/ml. The mean decay of insulin secretion over time was -13 +/- 3.2 microU/ml/min. Multiple regression analysis demonstrated that pancreata from donors who had a smoking history had a faster rate of decay of insulin secretion than pancreata from nonsmokers (P = 0.04). None of the other above mentioned donor factors significantly affected decay of insulin secretion. This analysis suggests that a history of smoking in organ donors results in a significantly faster rate of decay of insulin secretion when the pancreas is utilized for the laboratory model. We conclude that it is important to evaluate specific donor factors of cadaveric organ donors prior to the use of the human organs for experimental purposes.