The European Society for Organ Transplantation (ESOT) has developed a consensus on the role of perfusion machines in increasing the number of donors for beta cell replacement therapy (cells present in the pancreas). The working group that participated in its development was led by Dr. Joana Ferrer, surgeon in the General and Digestive Surgery Service and researcher in the IDIBAPS Hepatic Oncology working group and CIBEREHD.
The pancreas is especially susceptible to ischemia-reperfusion phenomena. Perfusion machines help assess the viability of the organ outside the body for a longer period of time. The advantages of using these devices with the kidneys and the liver have been extensively studied and their use has been indicated in these types of transplantation. However, to date, there have been no guidelines for their use in beta cell replacement therapy, which can be carried out through pancreas or islet cell transplantation.
The use of these devices in this type of therapy can help increase the donor pool for pancreas transplants. Moreover, beta cell replacement therapy is one of the main treatments for type 1 diabetes, a disease that has increased in incidence in recent years.
This consensus was reached by reviewing all the scientific evidence available in both preclinical and clinical studies. Once all the evidence had been reviewed, the working group, made up of experts in beta cell replacement therapy from different areas, established different recommendations based on the quality of the evidence.
Among the various recommendations contained in the guidelines, it should be noted that there is only evidence of quality in the use of normothermic machine perfusion in beta cell replacement therapy in humans. Therefore, none of the other perfusion modalities can currently be considered as an alternative for use in this field. Furthermore, the results obtained show that it is difficult to obtain quality data on organ preservation in this field, compared to other fields (such as the kidneys and the liver).
The use of these devices in pancreas transplantation is an emerging field, which has led to an increase in the number of studies in recent years. "This consensus provides the technical basis for guiding future clinical studies”, says Dr. Joana Ferrer. She adds, “It is important that the foundations are laid to guarantee future results in this field that are comparable and allow quality recommendations to be established".
Ferrer-Fàbrega Joana, Mesnard Benoît, Messner Franka, Doppenberg Jason B., Drachenberg Cinthia, Engelse Marten A., et al. European Society for Organ Transplantation (ESOT) Consensus Statement on the Role of Pancreas Machine Perfusion to Increase the Donor Pool for Beta Cell Replacement Therapy. Transplant International, 2023 (36). DOI: 10.3389/ti.2023.11374