31P nuclear magnetic resonance of rat pancreatic grafts

Pre-transplantation 31P-magnetic resonance spectroscopy for quality assessment of human pancreatic grafts - A feasibility study

OBJECTIVE

To investigate the feasibility of using ³¹P-MRS for objective non-invasive quality assessment of human pancreas grafts prior to transplantation or islet isolation.

MATERIALS AND METHODS

Pancreata from 5 human donors, 3 males and 2 females, aged 49-78years, with body mass index (BMI) 22-31kg/m², were included. Pancreata were perfused with histidine-tryptophan-ketoglutarate solution during procurement and stored in hypothermic condition (4°C) for 21-44h. During the period of hypothermic storage repeated spectra were obtained for each graft by ³¹P-MRS (1.5Tesla) to measure the cold ischemia time (CIT) dependent changes of the phosphorous metabolites adenosine triphosphate (ATP), phosphomonoesters (PME), phosphodiesters (PDE) and inorganic phosphate (Pi), in the grafts. Graft temperature was measured immediately before and after MR-examination. Reference spectrum for non-viable tissue was obtained after graft exposure to room temperature.

RESULTS

PME/Pi, PDE/Pi and ATP/Pi spectral intensities ratios decreased with increasing CIT, reflecting the decreased viability of the grafts. PME/Pi ratio was the most discriminatory variable at prolonged CIT. ³¹P-MRS could be performed without significantly increasing graft temperature.

CONCLUSIONS

³¹P-MRS may provide quantitative parameters for evaluating graft viability ex vivo, and is a promising tool for objective non-invasive assessment of the quality of human pancreas grafts prior to transplantation or islet isolation.

Objective and rapid assessment of pancreas graft viability using 31P-nuclear magnetic resonance spectroscopy combined with two- layer cold storage method

BACKGROUND

With the current shortage of donors, there is a critical need to optimally use "less-than-ideal" donors for pancreas transplantation. Objective and rapid means for assessing graft viability and suitability for transplantation are mandatory. This study examined the possibility of graft viability assessment and posttransplant outcome prediction using (31)P-nuclear magnetic resonance (NMR) spectroscopy combined with the two-layer cold-storage method (TLM).

METHODS

Canine pancreas grafts were preserved with TLM for 24 hours after 0, 60, or 120 minutes of warm ischemia (groups 1, 2, or 3, respectively). After preservation, we determined intragraft phosphate metabolites noninvasively using (31)P-NMR spectroscopy. Time required for this assessment was 5 minutes. Because our previous studies demonstrated that all grafts in groups 1 and 2 were successfully transplanted (the viable group), whereas all in group 3 failed to survive (the nonviable group), the possibility of posttransplant outcome prediction was examined on the basis of the comparison between these two groups.

RESULTS

The ratios of inorganic phosphate/gamma-adenosine triphosphate (Pi/gamma-ATP) and Pi/beta-ATP reflected the extent of graft damage, and the differences were statistically significant among groups 1, 2, and 3. On the basis of analyses of receiver operator characteristic curves, the optimum cutoff levels between the viable and nonviable groups were 1.6 and 2.2 for Pi/gammaATP and Pi/betaATP, respectively. The accuracy rates of these ratios were both 83%.

CONCLUSION

(31)P-NMR spectroscopy combined with TLM preservation could provide an objective, rapid, and possibly noninvasive means to assess pancreas graft viability and to determine suitability of damaged pancreata for organ transplantation.

Time-course magnetic resonance imaging of rat pancreatic cyst after experimental pancreatitis

Fast magnetic resonance (MR) imaging of the rat pancreas was carried out using a snapshot method to observe three-dimensional (3D) and temporal development of the pancreatic cyst after experimental pancreatitis. Acute pancreatitis was induced by a retrograde infusion of the trypsin-taurocholate solution into the pancreatic duct in 23 rats, of which seven survived for one month. Under 2% enflurane anesthesia, (1)H images of the rat abdomen were taken by a 4.7 T magnetic resonance spectrometer under spontaneous breathing. 3D images of the pancreas and cyst were reconstructed from the axial, sagittal and coronal images taken before, 24 h, 7 days, 14 days, 21 days and 28 days after the induction of pancreatitis. The 3D images reconstructed from different slice orientations at each time point showed good agreement with each other. The calculated volumes of the cyst on 7th, 14th, 21st, and 28th day were 0.3 +/- 0.1, 0.8 +/- 0.3, 2.1 +/- 0.6, 6.5 +/- 1.3 mL, respectively. The cystic fluid volume on 28th day was 6.4 +/- 1.4 mL, which confirmed reliability of volume measurement by MR imaging. Fast MR imaging (snapshot) together with 3D reconstruction allows us to understand the detailed chronological and spatial development of pancreatic cyst after acute pancreatitis in rats.

A method for in vivo assessment of reversible rat pancreatic ischemia using 31P NMR spectroscopy at 2.0 tesla

A surgical method is described which allows in vivo assessment of reversible rat pancreatic ischemia using 31P NMR spectroscopy at 2.0 T. Phosphorous-31 NMR spectra acquired during the ischemic period show the expected increase in inorganic phosphate with a concomitant decrease in ATP levels and pH as compared to controls. Upon reperfusion, inorganic phosphate and ATP returned to control levels while pH recovered to a more alkaline value. This method provides a means of studying in vivo changes in high energy metabolite associated with acute pancreatitis (AP) and maintains the secretory ability of the gland so that different forms of AP, such as those arising from pancreatic juice edema, can be studied.