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Updated: Sep 18, 2025
Normothermic Ex Vivo Pancreas Perfusion for the Preservation of Pancreas Allografts before Transplantation
Published on: July 27, 2022
Normothermic Ex Vivo Machine Perfusion Mitigates Apoptosis in a Porcine Model of Pancreas Transplantation
Catherine Parmentier1, Samrat Ray1, Masataka Kawamura1
1Multi Organ Transplant Department, Ajmera Transplant Centre, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
Background:
Pancreas transplantation is one of the most effective treatment options for individuals diagnosed with complicated diabetes. However, the pancreas has one of the strictest acceptance criteria and the highest discard rate of any organ after retrieval. Normothermic ex vivo perfusion (NEVP) has emerged as a promising strategy to evaluate and potentially improve the quality of pancreatic grafts before transplantation.
Methods:
Using a porcine model of pancreas transplantation, we compared 5 h of static cold storage (SCS; n = 4) with 2 h of SCS followed by 3 h of NEVP (n = 4). Parameters such as graft hemodynamics, blood biochemistry, and histopathology were evaluated. The animals were followed up for 3 d after transplantation.
Results:
A glucose tolerance test performed on day 3 was comparable between the 2 groups ( P = 0.71). The NEVP group exhibited a significantly lower number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells compared with the SCS group ( P = 0.01). Additionally, plasma and tissue levels of 8-hydroxy-2-deoxyguanosine were significantly lower in the NEVP group on postoperative day 3 compared with the SCS group ( P = 0.01). However, within-group comparisons did not show statistically significant changes over time.
Conclusions:
This study demonstrates that the addition of NEVP significantly reduces apoptosis after reperfusion and may help stabilize oxidative stress levels. These findings suggest that NEVP could be a valuable approach for improving the quality and viability of pancreatic grafts before transplantation, but further research is needed to confirm.
