Bacteremia due to Transplantation of Contaminated Cryopreserved Pancreatic Islets
Objective To report two cases of pancreatic islet transplantation-related septicemia, and the results of an investigative protocol to identify potential sources of contamination. Design Case series. Setting University hospital clinical investigational islet transplantation program. Results The last...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
1994-01-01
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| Series: | Cell Transplantation |
| Online Access: | https://doi.org/10.1177/096368979400300114 |
| _version_ | 1818144547330326528 |
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| author | Geoffrey D. Taylor Terri Kirkland Jonathan Lakey Ray Rajotte Garth L. Warnock |
| author_facet | Geoffrey D. Taylor Terri Kirkland Jonathan Lakey Ray Rajotte Garth L. Warnock |
| author_sort | Geoffrey D. Taylor |
| collection | DOAJ |
| description | Objective To report two cases of pancreatic islet transplantation-related septicemia, and the results of an investigative protocol to identify potential sources of contamination. Design Case series. Setting University hospital clinical investigational islet transplantation program. Results The last two of our first seven islet transplantation recipients developed Enterobacter cloacae septicemia within hours of islet infusion. Both had received thawed cryopreserved islet infusions. No source of infection apart from islets could be identified. Pancreas harvesting and islet isolation protocols provided multiple opportunities for contamination. Environmental cultures during a mock islet isolation procedure failed to identify a source of Enterobacter. Previously cryopreserved islet lots were thawed and submitted for culture, 14/47 grew micro-organisms including E. cloacae in four instances. Following revision of protocols for aseptic handling of islets during processing and cryopreservation 55 consecutive pancreata undergoing processing were evaluated; 7 grew micro-organisms on arrival and in 3 cases these persisted through to cryopreservation. Conclusion Two of seven islet transplantation recipients developed septicemia, likely related to infusion of contaminated cryopreserved islets. Using existing technology, for isolating islets from donor pancreata, recipients will remain at risk for this complication. Prevention should entail strict adherence to aseptic technique, and, possibly, use of surveillance microbial cultures during the islet isolation process. |
| first_indexed | 2024-12-11T11:49:18Z |
| format | Article |
| id | doaj.art-fc8a1c45000a411f8e8bfb5707451283 |
| institution | Directory Open Access Journal |
| issn | 0963-6897 1555-3892 |
| language | English |
| last_indexed | 2024-12-11T11:49:18Z |
| publishDate | 1994-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Cell Transplantation |
| spelling | doaj.art-fc8a1c45000a411f8e8bfb57074512832022-12-22T01:08:24ZengSAGE PublishingCell Transplantation0963-68971555-38921994-01-01310.1177/096368979400300114Bacteremia due to Transplantation of Contaminated Cryopreserved Pancreatic IsletsGeoffrey D. Taylor0Terri Kirkland1Jonathan Lakey2Ray Rajotte3Garth L. Warnock4 Departments of Medicine, Surgery, University of Alberta and ‡Infection Control Unit, University of Alberta Hospitals, Edmonton, Canada Departments of Medicine, Surgery, University of Alberta and ‡Infection Control Unit, University of Alberta Hospitals, Edmonton, Canada Departments of Medicine, Surgical-Medical Research Institute, University of Alberta and ‡Infection Control Unit, University of Alberta Hospitals, Edmonton, Canada Departments of Medicine, Surgery, University of Alberta and ‡Infection Control Unit, University of Alberta Hospitals, Edmonton, Canada Departments of Medicine, Surgical-Medical Research Institute, University of Alberta and ‡Infection Control Unit, University of Alberta Hospitals, Edmonton, CanadaObjective To report two cases of pancreatic islet transplantation-related septicemia, and the results of an investigative protocol to identify potential sources of contamination. Design Case series. Setting University hospital clinical investigational islet transplantation program. Results The last two of our first seven islet transplantation recipients developed Enterobacter cloacae septicemia within hours of islet infusion. Both had received thawed cryopreserved islet infusions. No source of infection apart from islets could be identified. Pancreas harvesting and islet isolation protocols provided multiple opportunities for contamination. Environmental cultures during a mock islet isolation procedure failed to identify a source of Enterobacter. Previously cryopreserved islet lots were thawed and submitted for culture, 14/47 grew micro-organisms including E. cloacae in four instances. Following revision of protocols for aseptic handling of islets during processing and cryopreservation 55 consecutive pancreata undergoing processing were evaluated; 7 grew micro-organisms on arrival and in 3 cases these persisted through to cryopreservation. Conclusion Two of seven islet transplantation recipients developed septicemia, likely related to infusion of contaminated cryopreserved islets. Using existing technology, for isolating islets from donor pancreata, recipients will remain at risk for this complication. Prevention should entail strict adherence to aseptic technique, and, possibly, use of surveillance microbial cultures during the islet isolation process.https://doi.org/10.1177/096368979400300114 |
| spellingShingle | Geoffrey D. Taylor Terri Kirkland Jonathan Lakey Ray Rajotte Garth L. Warnock Bacteremia due to Transplantation of Contaminated Cryopreserved Pancreatic Islets Cell Transplantation |
| title | Bacteremia due to Transplantation of Contaminated Cryopreserved Pancreatic Islets |
| title_full | Bacteremia due to Transplantation of Contaminated Cryopreserved Pancreatic Islets |
| title_fullStr | Bacteremia due to Transplantation of Contaminated Cryopreserved Pancreatic Islets |
| title_full_unstemmed | Bacteremia due to Transplantation of Contaminated Cryopreserved Pancreatic Islets |
| title_short | Bacteremia due to Transplantation of Contaminated Cryopreserved Pancreatic Islets |
| title_sort | bacteremia due to transplantation of contaminated cryopreserved pancreatic islets |
| url | https://doi.org/10.1177/096368979400300114 |
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