Optimal implantation site for pancreatic islet transplantation

被引:208
作者
Merani, S. [2 ]
Toso, C. [2 ]
Emamaullee, J. [2 ]
Shapiro, A. M. J. [1 ,2 ]
机构
[1] Univ Alberta, Clin Islet Transplant Program, Roberts Ctr, Edmonton, AB T6G 2C8, Canada
[2] Univ Alberta, Surg Med Res Inst, Edmonton, AB T6G 2C8, Canada
基金
瑞士国家科学基金会;
关键词
D O I
10.1002/bjs.6391
中图分类号
R61 [外科手术学];
学科分类号
摘要
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.
引用
收藏
页码:1449 / 1461
页数:13
相关论文
共 104 条
[1]  
ADAMS GA, 1994, SURGERY, V116, P751
[2]  
ADAMS GA, 1994, SURGERY, V116, P756
[3]   SITE FOR UNPURIFIED ISLET TRANSPLANTATION IS AN IMPORTANT PARAMETER FOR DETERMINATION OF THE OUTCOME OF GRAFT-SURVIVAL AND FUNCTION [J].
ALABDULLAH, IH ;
KUMAR, MSA ;
KELLYSULLIVAN, D ;
ABOUNA, GM .
CELL TRANSPLANTATION, 1995, 4 (03) :297-305
[4]   ISLET AUTO-TRANSPLANTATION IN THE PANCREATECTOMIZED DOG - EFFECT OF TIME ON GRAFT FUNCTION [J].
ALDERSON, D ;
FARNDON, JR ;
ALBERTI, MM ;
PATH, MRC ;
JOHNSTON, IDA .
WORLD JOURNAL OF SURGERY, 1984, 8 (04) :590-597
[5]   ISLET CELL TRANSPLANTATION IN DIABETIC DOGS - STUDIES OF GRAFT FUNCTION AND STORAGE [J].
ALDERSON, D ;
WALSH, TN ;
FARNDON, JR .
BRITISH JOURNAL OF SURGERY, 1984, 71 (10) :756-760
[6]   NATURAL-HISTORY OF INTRAHEPATIC CANINE ISLET CELL AUTOGRAFTS [J].
ALEJANDRO, R ;
CUTFIELD, RG ;
SHIENVOLD, FL ;
POLONSKY, KS ;
NOEL, J ;
OLSON, L ;
DILLBERGER, J ;
MILLER, J ;
MINTZ, DH .
JOURNAL OF CLINICAL INVESTIGATION, 1986, 78 (05) :1339-1348
[7]  
ANDERSSON A, 1981, DIABETOLOGIA, V20, P237
[8]  
AO Z, 1992, TRANSPLANT P, V24, P2789
[9]   SURVIVAL AND FUNCTION OF PURIFIED ISLETS IN THE OMENTAL POUCH SITE OF OUTBRED DOGS [J].
AO, ZL ;
MATAYOSHI, K ;
LAKEY, JRT ;
RAJOTTE, RV ;
WARNOCK, GL .
TRANSPLANTATION, 1993, 56 (03) :524-529
[10]   CT-guided fine-needle approach for intrathymic islet transplantation in a diabetic patient [J].
AriasDiaz, J ;
Vara, E ;
Balibrea, JL ;
Garcia, C ;
Maranes, A ;
Diaz, A ;
Lezana, AH ;
Gallego, J ;
Rodriguez, R ;
Maranes, JP ;
Barrientos, A .
PANCREAS, 1996, 12 (01) :100-103