[Coagulation activation with intraportal islets of Langerhans transplantation in swine].
OBJECTIVE
Intraportal islet allograft appears to be one of the promising treatments for type I diabetes. However, many limiting factors persist. An activation of the coagulation cascade upon contact with islets, has been reported recently in vitro and could play a crucial role in a non specific inflammatory reaction and favour the specific immune reaction. The aim of this experimental study was to confirm in vivo this activation of the coagulation cascade.


METHODS
An allogenic islets preparation or a material control (inert microbeads) was injected intraportally, in Large White pigs (n = 26), associated with or without an anticoagulant treatment (heparin). Systemic markers of haemostasis were measured in pigs for 72 hours following injection of the studied material.


RESULTS
The thrombin-antithrombin complex increased and platelet count decreased in groups receiving preparation of islets, both indicators of an activation of the coagulation cascade. This activation was proportional to the injected volume and was partially attenuated by heparin. No activation was observed in pigs receiving the material control.


CONCLUSIONS
The activation of the coagulation cascade and the non specific inflammatory reaction could be one of the obstacles to the success of the islet allografts. The use of anticoagulant and anti-inflammatory molecules could potentially allow an improvement of the present results of islet allograft.
Lamblin
A
A
Equipe Inserm ERM 106, thérapie cellulaire du diabète, pôle recherche, faculté de médecine, université de Lille II, 1, place de Verdun, 59037 Lille, France.
Tournoys
A
A
Gmyr
V
V
Jourdain
M
M
Lefebvre
J
J
Kerr-Conte
J
J
Proye
C
C
Pattou
F
F
D000818:Animals; D001777:Blood Coagulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D011169:Portal Vein; D013552:Swine