05-1: NO BLOOD? NO PROBLEM: BLOOD-FREE PERFUSION HUMAN AND PORCINE PANCREASES – A FEASIBILITY STUDY
Bibliographic record
Abstract
Introduction: High discard rates of donor pancreases limit their use in transplantation and islet isolation. Normothermic machine perfusion (NMP) offers a platform to assess and enhance pancreatic viability. Traditionally, NMP relies on blood-based perfusates or oxygen carriers, posing logistical challenges. This study evaluates the feasibility of blood-free NMP in both human and porcine pancreas models. Methods: Five discarded human pancreases were perfused for 6-hours with blood- and oxygen-carrier-free perfusate and compared to six historical controls perfused with blood for 4-hours. All grafts were used for tissue slicing and calcium imaging, with three halves used for islet isolation. Four porcine grafts with minimal warm ischemia and 2-hours of cold ischemia were perfused for 3-hours using a blood-free perfusate, while four were perfused with a blood-based perfusate. Grafts were transplanted, and recipients were monitored until POD3. One blood-free case was excluded due to graft thrombosis, and one blood-based case due to technical issues. Results: In the human model, the blood-free group showed lower mean amylase levels (p=0.04) and higher mean C-peptide levels (p=0.03). Histology revealed no differences between baseline and 6-hours, confirming preserved pancreatic integrity. Islet isolation was successful in two blood-free cases, with glucose-stimulated insulin secretion comparable to blood-based controls. Calcium imaging further demonstrated an oscillatory response, indicating functional islets. In the porcine model, all recipients survived until POD3. Postoperative enzymatic activity was higher in blood-free recipients, though variability was observed. One recipient had markedly elevated enzyme levels while remaining asymptomatic. The glucose tolerance test showed comparable regulation between groups (p=0.49). Histology at POD3 showed mild to moderate necrosis and edema in both groups, with regenerative changes suggesting healing. Conclusions: These findings support blood-free NMP as a feasible alternative to blood-based methods. By preserving pancreatic viability and demonstrating comparable transplantation and islet outcomes, blood-free perfusion addresses logistical challenges and warrants further investigation with larger cohorts.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".