The pancreas undergoes enzymatic with collagenase and proteinase and mechan­ical digestion via the Ricordi digestion isolation changer to yield islet isolates [18]. To initiate tissue digestion and dissolution, collagenase and proteinase are infused under pressure into the main pancreatic duct to distend the intact gland. After dis­ruption, the pancreas is sectioned and placed in a Ricordi digestion isolation cham­ber for gentle mechanical dispersion until the islets are separated from acinar tissue as detected by microscopic analysis with dithizone staining. The extent of islet puri­cation is imprecise as a balance must be achieved between purifying the islets away from surrounding tissue (to reduce the volume of the infusate and minimize thrombogenic particulate matter) while preserving the absolute number of islets with each successive purication cycle. Purication is achieved through continuous density gradient centrifugation. Final islet counts can be determined using an auto­mated islet counter or standard manual counting methods, commonly reported as a standardized islet equivalent and islet equivalent per kilogram of body weight. One islet equivalent is equal to the volume of an islet with a diameter of 150μm. Mean islet yield from large case series are listed in Table 10.2. Before transplant, islet preparations are suspended in a 50:50 solution of 20% human serum albumin and transplant media with antibiotics solution, such as ciprooxacin. Although there is bacterial contamination from the attached duodenum, there is no clinical benet to routinely culture this islet preparation. In our retrospective analysis, up to 65% of patients will have positive intraoperative cultures with no difference in infectious complication rate [19].