[Transplantation of porcine Langerhans islets for therapy of type I diabetes. The way to clinical application].
Transplantation of isolated pancreatic islets provides an interesting alternative to the present cure for diabetes: insulin injections and pumps. These are characterized by an insufficient glucose haemostasis and in the long run can induce kidney failure, blindness, heart failure, and amputations. Up to now more than 293 allogeneic islet transplantations have been performed in diabetics with chronical kidney failure. Despite some success, no real breakthrough has been yet achieved, though great efforts are being made to improve the various methodological steps on the way to clinical transplantation. The use of animal (xenogeneic) organs could be a solution to overcome the shortage of allogeneic donors. The current experimental and clinical research focuses on the use of pigs as organ donors, which have a number of advantages over the immunologically more compatible primates. This article reports on success and open questions concerning the efforts to isolate porcine islets for future clinical transplantation: the search for a suitable pig breed, the various isolation steps, purification and in vitro culture, transplantation models using-small and large animals, first clinical trials, and immunological reactions against the xenogeneic tissue. In addition, strategies to circumvent tissue rejection and future perspectives are discussed.
Ulrichs
K
K
Chirurgische Universitätsklinik und Poliklinik, Julius-Maximilians-Universität Würzburg.
Hamelmann
W
W
Bühler
C
C
Beutner
U
U
Meyer
T
T
Otto
C
C
Klöck
G
G
Thiede
A
A
D000464:Alginates; D000818:Animals; D000910:Antibodies, Heterophile / Q000276:immunology; D001672:Biocompatible Materials; D002214:Capsules; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000601:surgery*; D020723:Glucuronic Acid; D006085:Graft Survival / Q000276:immunology; D006603:Hexuronic Acids; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000276:immunology; D013552:Swine; D014183:Transplantation, Heterologous / Q000276:immunology
D000464:Alginates; D000910:Antibodies, Heterophile; D001672:Biocompatible Materials; D002214:Capsules; D006603:Hexuronic Acids; D020723:Glucuronic Acid