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P.103 Donors from Distant Hospitals can Provide Successful Islet Transplant Outcomes: The Westmead Experience a National Islet Transplant Centre

Wayne J Hawthorne, Australia

Professor
Surgery
Westmead Hospital

Biography

Professor Wayne Hawthorne is the President of the International Xenotransplantation Association (IXA) and President of the Australasian College of Biomedical Scientists. He is the Director of the clinical and experimental islet isolation and xeno-transplant research teams at Westmead; appointed as laboratory director in 2001 on Australia's First Clinical Islet Transplant program at Westmead; his team were the first in Australia to perform both allo and auto islet cell isolation and transplantation and to perform islet after kidney and combined islet/kidney transplants in patients. He was one of the founding researchers of the Centre for Transplant and Renal Research where he remains responsible for experimental surgical research projects. In 2003 he became the Inaugural winner of the McKenzie Fellowship for Transplantation from the Transplant Society of Australia and New Zealand (TSANZ). In 2007, he was awarded A “Key Opinion Leader” in transplantation by The Transplantation Society International. In 2010 he was awarded the prestigious XENOME Award for transplantation from the European Union, at the 16th Nantes/Actualités/Transplantation in France. In 2011 he was promoted to Associate Professor, Department of Surgery, Westmead based on his continued work developing transplantation treatments for patients with Type 1 diabetes. Since this time he has built on the experimental research program’s achievements, resulting in his award of the 2014 Kidney Health Australia and the TSANZ “Best Research in the Field of Laboratory Research” for his work on developing novel strategies for Islet Cell Xenotransplantation in preclinical studies. More recently he was awarded a 2015-16 Australia-Harvard-Fellowship to further develop his skills in islet auto-transplantation at Harvard University and Beth Israel Deaconess Medical Center, Boston, USA. He is the Chair of the Organising Committee for the combined IXA/CTS 2021 congress and is on a number of abstract review committees for Scientific meetings of both the International and National Transplant Societies. Wayne has been Convener and Organiser of the TSANZ postgraduate training course and the previous Congress of the Transplantation Society International.

Abstract

Donors from Distant Hospitals can Provide Successful Islet Transplant Outcomes: The Westmead Experience a National Islet Transplant Centre

Wayne Hawthorne1,2,3,4, Sussan Davies1, Hee-chang Mun1, Yi vee Chew1, Lindy Wiliams1, Trish Anderson4, Natasha Rogers1,2,4, Philip O’Connell1,2,4.

1Centre for Transplant and Renal Research, Westmead Institute of Medical Research, Westmead, Australia; 2Westmead Medical School, The University of Sydney, Westmead, Australia; 3Department of Surgery, Westmead Hospital, Westmead , Australia; 4National Pancreas and Islet Transplant Unit, Westmead Hospital, Westmead, Australia

Australian National Islet Transplant Consortium.

Background: Islet cell isolation is dependent upon numerous variables, by far the most influential factors seen are those from the donor. In Australia there are significant distances to travel to obtain donors at distant Hospitals and as such travel time can adversely affect outcomes of islet isolation. The aim of this study was to compare the isolation and transplant outcomes of donor pancreata according to the distance from Westmead Hospital the islet isolation facility. Local and distant donors from around Australia were compared.
Methods: Donors were categorised according to distance from the National Pancreas Transplant Unit Westmead (NPTU). Including; age, BMI, cause and mechanism of death, days in ICU, gender, inotrope and steroid use, cold ischemia time (CIT) and donor surgical team.
Results: Between March 2007 and December 2020, 297 islet isolations were performed at our centre 149 donor pancreata were local, and 148 non-local regions. Mean distance from the isolation facility was 780.05 km. Mean pancreas CIT was 401.07 ± 137.71 minutes and was significantly different between local and non-local groups (297.2 vs. 487.5 minutes, p<0.01). Mean age of donors was 45.22 years, mean BMI was 28.82, sex ratio was 48:52 F:M and mean time in ICU was 3.07 days. There was no significant difference between local and non-local for these characteristics. The mean CIT resulting in islet transplantation was 297.1 ± 91.5 min and longest CIT resulting in transplantation was 676 minutes.  There was no significant difference in islet isolation outcomes between local and non-local donors for characteristics other than CIT. There was also no significant effect of distance from the isolation facility on positive islet transplant outcomes (C-peptide >0.2 at 1-month post-transplant).
Conclusions: Distance from the isolation centre does not impact on isolation or transplant outcomes supporting the ongoing nationwide use of shipping pancreata for islet isolation and transplantation.