Development and Application of a Semi quantitative Scoring Method for Ultrastructural Assessment of Acute Stress in Pancreatic Islets

• Published in: Transplantation direct 2021-12, Vol.8 (1), p.e1271-e1271
• Main Authors: Dyson, Nicola J., Kattner, Nicole, Honkanen-Scott, Minna, Hunter, Bethany, Doyle, Jennifer A., White, Kathryn, Davey, Tracey S., Ploeg, Rutger J., Bury, Yvonne A., Tiniakos, Dina G., Shaw, James A. M., Scott, William E.
• Format: Article
• Language: English
• Subjects: Pancreas and Islet Transplantation
• ISSN: 2373-8731; 2373-8731
• DOI: 10.1097/TXD.0000000000001271

Pancreas and islet transplantation outcomes are negatively impacted by injury to the endocrine cells from acute stress during donor death, organ procurement, processing, and transplant procedures. Here, we report a novel electron microscopy scoring system, the Newcastle Pancreas Endocrine Stress Score (NPESS). NPESS was adapted and expanded from our previously validated method for scoring pancreatic exocrine acinar cells, yielding a 4-point scale (0-3) classifying ultrastructural pathology in endocrine cell nuclei, mitochondria, endoplasmic reticulum, cytoplasmic vacuolization, and secretory granule depletion, with a maximum additive score of 15. We applied NPESS in a cohort of deceased organ donors after brainstem (DBD) and circulatory (DCD) death with a wide range of cold ischemic times (3.6-35.9 h) including 3 donors with type 1 and 3 with type 2 diabetes to assess islets in situ (n = 30) in addition to pancreata (n = 3) pre- and postislet isolation. In DBD pancreata, NPESS correlated with cold ischemic time (head: r = 0.55;  = 0.02) and mirrored exocrine score (r = 0.48;  = 0.01). When stratified by endocrine phenotype, cells with granules of heterogeneous morphology had higher scores than α, β, and δ cells (