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Current progress and perspectives in immunoisolated islet transplantation
Y Mullen1, M Maruyama, C V Smith
1Islet Transplant Program, Department of Surgery, UCLA School of Medicine, Bldg 304, Rm E1-206, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA.
Journal of Hepato-Biliary-Pancreatic Surgery
|February 17, 2001
Summary
Immunoisolated islet transplantation shows promise for diabetes treatment, but challenges remain in large animal models. Improving device materials and minimizing inflammation are key for clinical success.
Area of Science:
- Immunology
- Transplantation Biology
- Biomaterials Science
Background:
- Islet transplantation is a potential therapy for diabetes.
- Immunoisolation aims to prevent immune rejection of transplanted islets.
- Progress has been made in both allogeneic and xenogeneic islet transplantation.
Purpose of the Study:
- To review recent advances in immunoisolated islet transplantation.
- To identify challenges hindering clinical application, particularly in large animal models.
- To highlight areas for future research and development.
Main Methods:
- Review of studies on alginate microcapsules and immunoisolation devices.
- Analysis of islet transplantation outcomes in various animal models (dogs, monkeys, rodents).
- Evaluation of factors influencing graft survival, including device design and inflammatory responses.
Main Results:
- Alginate microcapsules showed success in diabetic dogs and monkeys, but results were inconsistent.
- Vascularized bioartificial devices achieved long-term survival in dogs, though thrombosis was a major issue.
- Diffusion chambers succeeded in rodents but have not been reported in larger animals.
Conclusions:
- Significant progress in islet immunoisolation, but consistent success in large animals is limited.
- Clinical translation requires improved quality control of islets, membranes, and device construction.
- Minimizing inflammatory reactions to immunoisolation devices is crucial for successful islet transplantation.