The pancreas is one of the most difficult organs to preserve between donation and transplantation, and the standard approach, static cold storage on ice, slows deterioration without preventing it. Partly as a result, up to half of donated pancreases are never used. A clinical study at the University of Oxford has now recruited its first participant, in doing so performing the world's first successful transplant of a human pancreas preserved by oxygenated hypothermic machine perfusion.
The Hypothermic Oxygenated Pancreas Perfusion study, led from the Nuffield Department of Surgical Sciences, will recruit 30 patients from the simultaneous kidney and pancreas transplant waiting list at Oxford University Hospitals NHS Foundation Trust. Each donor pancreas is perfused with oxygenated cold fluid for two hours while the recipient's kidney transplant is under way, before being transplanted using standard surgical techniques. Outcomes will be compared with 60 recent patients whose organs were kept in conventional cold storage.
Machine perfusion supplies oxygen and removes harmful metabolites, and has already transformed kidney and liver transplantation. For people with severe diabetes, a successful pancreas transplant can restore normal blood glucose control and end dependence on insulin therapy. If the technique improves organ quality as hoped, it could reduce post-transplant complications and expand the pool of usable organs, with researchers tracking pancreas and kidney function, complications and length of hospital stay.