Clinical Islet Xenotransplantation: Development of Isolation Protocol, Anti-Rejection Strategies, and Clinical Outcomes.
This review traces the development of clinical islet xenotransplantation, covering islet isolation protocols, anti-rejection strategies, and the clinical trials conducted to date as a potential solution to the donor shortage in type 1 diabetes.
Background
Allogeneic islet transplantation has become a standard therapy for unstable type 1 diabetes, but given the large number of patients, the shortage of human donors is a serious issue. Clinical islet xenotransplantation, using porcine islets, is being pursued to address this limitation.
Key recommendations
The review describes how the first clinical islet xenotransplantation was performed by a Swedish team using fetal pancreatic tissue, followed by trials in New Zealand, Russia, Mexico, Argentina, and China using neonatal pig islets. Fetal or neonatal pancreata are used because of established reliable islet isolation methods, and these trials have demonstrated the safety and efficacy of the approach.
Clinical implications
The authors note that the limited number of source-animal facilities remains a barrier to advancing islet xenotransplantation, owing to high cost and uncertainty about the field's future. They point to the first xenogeneic heart transplantation in the United States and organizational efforts such as Japan's Medical Porcine Development Association as developments that could help bring xenotransplantation closer to clinical reality.
Category
Transplant
Source
Cells
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