Optimal implantation site for pancreatic islet transplantation
Journal of British Surgery, 2008•academic.oup.com
Background Since the first report of successful pancreatic islet transplantation to reverse
hyperglycaemia in diabetic rodents, there has been great interest in determining the optimal
site for implantation. Although the portal vein remains the most frequently used site clinically,
it is not ideal. About half of the islets introduced into the liver die during or shortly after
transplantation. Although many patients achieve insulin independence after portal vein
infusion of islets, in the long term most resume insulin injections. Methods This review …
hyperglycaemia in diabetic rodents, there has been great interest in determining the optimal
site for implantation. Although the portal vein remains the most frequently used site clinically,
it is not ideal. About half of the islets introduced into the liver die during or shortly after
transplantation. Although many patients achieve insulin independence after portal vein
infusion of islets, in the long term most resume insulin injections. Methods This review …
Background
Since the first report of successful pancreatic islet transplantation to reverse hyperglycaemia in diabetic rodents, there has been great interest in determining the optimal site for implantation. Although the portal vein remains the most frequently used site clinically, it is not ideal. About half of the islets introduced into the liver die during or shortly after transplantation. Although many patients achieve insulin independence after portal vein infusion of islets, in the long term most resume insulin injections.
Methods
This review considers possible sites and techniques of islet transplantation in small and large animal models, and in humans. Metabolic, immunological and technical aspects are discussed.
Results and conclusion
Many groups have sought an alternative site that might offer improved engraftment and long-term survival, together with reduced procedure-related complications. The spleen, pancreas, kidney capsule, peritoneum and omental pouch have been explored. The advantages and disadvantages of various sites are discussed in order to define the most suitable for clinical use and to direct future research.
Oxford University Press