Studies of human fetal pancreatic allografts in diabetic recipients without immunosuppression

Four Type I insulin-dependent diabetic men received minced tissue from 6-12 pooled fetal pancreata cultured for 48 hours. Immunosuppressive therapy was not given. The tissue was transplanted under local anesthesia into the brachioradialis muscle of the nondominant arm or below the subcutaneous adipose tissue of the left lower quadrant of the abdominal wall. An increase in C-peptide secretion was documented following each procedure. Detectable C-peptide secretory capacity has persisted for 1 year in three cases. The total insulin requirement showed a drop of 71-100% at the time of maximum C-peptide secretion. No increase in anticytoplasmic islet cell antibody titer was detected during the year of observation following transplantation. These studies document that transplantation of functioning fetal pancreatic insulin-secreting tissue can be performed with minimal operative or immunologic risk to the recipient. Significant insulin secretory capacity persists for 1 year following implantation. Further studies are warranted in order to optimize insulin secretion following fetal pancreatic islet transplantation.