title: Current status of islet xenotransplantation.
abstract: Cell therapy for Type 1 diabetes (T1D) utilizing islet cell transplantation can successfully restore endogenous insulin production in affected patients. Islet cell engraftment and survival are conditional on the use of efficacious anti-rejection therapies and on the availability of healthy donor cells. The scarcity of healthy human donor pancreata is a limiting factor in providing sufficient tissue to meet the demand for islet transplantation worldwide. A potential alternative to the use of cadaveric human donor pancreases is the use of animal sourced islets. Pancreatic islets obtained from pigs have emerged as an alternative to human tissues due to their great availability, physiological similarities to human islets, including the time-tested use of porcine insulin in diabetic patients and the ability to genetically modify the donor source. The evolution of refined, efficacious immunosuppressive therapies with reduced toxicity, improvements in donor management and genetic manipulation of the donor have all contributed to facilitate long-term function in pre-clinical models of pig islet grafts in non-human primates. As clinical consideration for this option is growing, and trials involving the use of porcine islets have begun, more compelling experimental data suggest that the use of pig islets may soon become a viable, safe, effective and readily available treatment for insulin deficiency in T1D patients.
authors.affiliation: Department of Microbiology and Immunology, Xenotransplantation Research Center, Institute of Endemic Diseases, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea; Department of Biomedical Sciences, Seoul National University, Seoul, South Korea. Electronic address: chgpark@gmail.com.
authors.forename: Chung-Gyu
authors.initials: CG
authors.lastname: Park
authors.affiliation: Institute of Cellular Therapeutics, Allegheny Health Network, Pittsburgh, PA 15212, USA. Electronic address: RBottino@wpahs.org.
authors.forename: Rita
authors.initials: R
authors.lastname: Bottino
authors.affiliation: The Centre for Transplant & Renal Research, Westmead Research Institute, Westmead, NSW, Australia; Department of Surgery, University of Sydney at Westmead Hospital, Westmead, NSW, Australia. Electronic address: wayneh@med.usyd.edu.au.
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Hawthorne
mesh_terms: D000818:Animals; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D011323:Primates; D013552:Swine; D014019:Tissue Donors; D014183:Transplantation, Heterologous / Q000379:methods
keywords: Hyperacute rejection; Instant blood-mediated inflammatory reaction; Islet transplantation; Neonatal islet cell clusters; Thrombosis; Type 1 diabetes; Xenotransplantation