Body mass index of pancreatic donors: a decisive factor for human islet isolation

Despite improvements in islet isolation techniques, islet transplantation remains unpredictable as a method for reliably rendering human type I diabetic recipients normoglycemic. Advances in immunosuppression to prevent primary nonfunction, to promote engraftment and to prevent rejection should improve success rates. However, factors influencing the isolation process remain incompletely defined. During our experience, the donor's nutritional status as well as other donor characteristics were noted to be associated with islet isolation success. Thus, in this study, we tried to clarify whether the body mass index of the human pancreatic donor affects islet isolation yield and viability. In lean donors we found significantly lower islet yields in comparison with normal and obese donors and a significantly lower islet viability compared to obese donors. Obese donor islets had a significantly higher insulin secretory capacity than lean and normal donor islets. In summary, islet yield and viability were improved selecting pancreata from obese donors associated with a BMI > 24 for islet preparation. We hypothesize that, on the one hand, the increased distribution of fat in pancreata of obese donors possibly can facilitate the release of islets during the collagenase digestion, and, on the other hand, pancreata of obese donors contain more islets than pancreata of lean donors. These data underline the decisive influence of the pancreas donor's body mass index on successful human islet isolation. The body mass index should be noted as a potential predictor of success of islet preparations.