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Effects of remote ischemic preconditioning on intraportal islet transplantation in a rat model.
Transplant International 2018 October 15
Remote ischemic preconditioning (RIPC), which is the intermittent interruption of blood flow to a site distant from the target organ, is known to improve solid organ resistance to ischemia-reperfusion injury. This procedure could be of interest in islet transplantation to mitigate hypoxia-related loss of islet mass after isolation and transplantation. Islets isolated from control or RIPC donors were analyzed for yield, metabolic activity, gene expression and high mobility group box-1 (HMGB1) content. Syngeneic marginal mass transplantation was performed in four streptozotocin-induced diabetic groups: control, RIPC in donor only, RIPC in recipient only, and RIPC in donor and recipient. Islets isolated from RIPC donors had an increased retrieval of 20% after 24 hours of culture compared to control donors (p=0.007), linked to less cell death (p=0.08), decreased expression of hypoxia-related genes (Hif1a p=0.04; IRP94 p=0.008), and increased intra-cellular (p=0.04) and nuclear HMGB1. The use of RIPC in recipients only never allowed for reversal of diabetes, with increased serum HMGB1 at day 1; the three other groups demonstrated significantly better outcomes. Performing RIPC in the donors increases islet retrieval and resistance to hypoxia. Validation is needed, but this strategy could help to decrease the number of donors per islet recipient. This article is protected by copyright. All rights reserved.
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