title: Progress in Clinical Encapsulated Islet Xenotransplantation.
abstract: At the 2015 combined congress of the Cell Transplant Society, International Pancreas and Islet Transplant Association, and International Xenotransplantation Association, a symposium was held to discuss recent progress in pig islet xenotransplantation. The presentations focused on 5 major topics - (1) the results of 2 recent clinical trials of encapsulated pig islet transplantation, (2) the inflammatory response to encapsulated pig islets, (3) methods to improve the secretion of insulin by pig islets, (4) genetic modifications to the islet-source pigs aimed to protect the islets from the primate immune and/or inflammatory responses, and (5) regulatory aspects of clinical pig islet xenotransplantation. Trials of microencapsulated porcine islet transplantation to treat unstable type 1 diabetic patients have been associated with encouraging preliminary results. Further advances to improve efficacy may include (1) transplantation into a site other than the peritoneal cavity, which might result in better access to blood, oxygen, and nutrients; (2) the development of a more biocompatible capsule and/or the minimization of a foreign body reaction; (3) pig genetic modification to induce a greater secretion of insulin by the islets, and/or to reduce the immune response to islets released from damaged capsules; and (4) reduction of the inflammatory response to the capsules/islets by improvements in the structure of the capsules and/or in genetic engineering of the pigs and/or in some form of drug therapy. Ethical and regulatory frameworks for islet xenotransplantation are already available in several countries, and there is now a wider international perception of the importance of developing an internationally harmonized ethical and regulatory framework.
authors.affiliation: 1 Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA. 2 Otsuka Pharmaceutical Factory, Tateiwa, Muya-cho, Naruto Tokushima, Japan. 3 Hospital Eva Peron de San Martin, Buenos Aires, Argentina. 4 Department of Regenerative Medicine and Transplantation, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka, Japan. 5 Laboratory of Surgery and Transplantation, Catholic University of Louvain, Brussels, Belgium. 6 Gene Center, LMU Munich and German Center for Diabetes Research (DZD), Munich, Germany. 7 Transplantation Immunology Unit, Padua University Hospital, and the Consortium for Research in Organ Transplantation (CORIT), Padua, Italy.
authors.forename: David K C
authors.initials: DK
authors.lastname: Cooper
authors.forename: Shinichi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Adrian
authors.initials: A
authors.lastname: Abalovich
authors.forename: Takeshi
authors.initials: T
authors.lastname: Itoh
authors.forename: Nizar I
authors.initials: NI
authors.lastname: Mourad
authors.forename: Pierre R
authors.initials: PR
authors.lastname: Gianello
authors.forename: Eckhard
authors.initials: E
authors.lastname: Wolf
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cozzi
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D006801:Humans; D007249:Inflammation / Q000209:etiology; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects; D013552:Swine; D014183:Transplantation, Heterologous
chemical_list: D007328:Insulin