International workshop: islet transplantation without borders enabling islet transplantation in Greece with international collaboration and innovative technology

Abstract

Recently, initiatives have been undertaken to establish an islet transplantation program in Athens, Greece. A major hurdle is the high cost associated with the establishment and maintenance of a clinical-grade islet manufacturing center. A collaboration was established with the University Hospitals of Geneva, Switzerland, to enable remote islet cell manufacturing with an established and validated fully operational team. However, remote islet manufacturing requires shipment of the pancreas from the procurement to the islet manufacturing site (in this case from anywhere in Greece to Geneva) and then shipment of the islets from the manufacturing site to the transplant site (from Geneva to Athens). To address challenges related to cold ischemia time of the pancreas and shipment time of islets, a collaboration was initiated with the University of Arizona, Tucson, USA. An international workshop was held in Athens, December 2011, to mark the start of this collaborative project. Experts in the field presented in three main sessions: (i) islet transplantation: state-of-the-art and the "network approach"; (ii) technical aspects of clinical islet transplantation and outcomes; and (iii) islet manufacturing - from the donated pancreas to the islet product. This manuscript presents a summary of the workshop.

Fig. 1

The Athens-Geneva-Tucson collaboration, showing the flow-chart of pancreas harvested in Greece transported to Switzerland for islet cell manufacturing, followed by shipment of islets to Greece. The long distance between Athens and Geneva requires the implementation of innovative new technologies and expertise for organ preservation and islet shipment that are contributed by the Tucson group.

Fig. 2

The centers participating in the GRAGIL (Groupe Rhin – Rhône – Alpes et Genève pour la greffe d'Îlots de Langerhans) network.

Fig. 3

The National Commisioning Group (NCG) and National Scottish Islet Transplant Centres network for islet cell transplantation in the United Kingdom. Red circles, NCG Islet Transplant Centre; blue circle, National Scottish Islet Transplant Centre.

Fig. 4

Schematic representation of the gaseous oxygen persufflation set-up used for the condition of livers during hypothermic preservation. From ref .

Fig. 5

Schematic depicting a silicone rubber vessel within specially designed gyroscopic container enabling upright positioning of the silicone rubber vessel irrespective of the position and orientation of the gyroscopic container.