Auto islet isolation: Methods in removal and isolation from fibrosed and autolyzed pancreata

Autologous islet transplant after total pancreatectomy offers the prospect of insulin independence for individuals undergoing treatment for pancreatitis. Several factors can affect patient outcomes including degree of disease progression and prior treatment. Arguably, tissue processing exerts the greatest influence on patient outcomes and almost always requires adjunctive enzymatic and mechanical modifications due to the presence of fibrotic tissue and ductal obstructions characteristic of pancreatitis. These modifications can include the utilization of enzyme blends with greater altered collagenase ratios, increased overall neutral protease concentrations, premincing of tissues, and pancreatic ductal stone ablation prior to enzyme perfusion. Simultaneously, auto islet preparations must be monitored for bacterial contamination, viability, and overall mass as these factors can contribute negatively to patient outcomes. Autologous islet transplant can provide positive outcomes for patients suffering from chronic pancreatitis with auto islet grafts conferring insulin independence for decades in some patients.