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Pig islet xenotransplantation.

Maheswaran Dhanasekaran1, Johnathan J George, Gopalakrishnan Loganathan

  • 1Department of Surgery, Clinical Islet Cell Laboratory, Cardiovascular Innovation Institute, University of Louisville, Louisville, Kentucky, USA.

Current Opinion in Organ Transplantation
|August 1, 2017
PubMed
Summary

Pig islets offer a promising solution for type 1 diabetes treatment, with clinical trials showing reduced insulin needs and fewer hypoglycemic episodes. Ongoing research addresses immune rejection and porcine endogenous retroviruses (PERVs) for safer xenotransplantation.

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Area of Science:

  • Endocrinology
  • Transplantation Immunology
  • Genetics

Background:

  • Type 1 diabetes requires islet transplantation, but human islet supply is limited.
  • Pig islets are a potential alternative source for transplantation.
  • Xenotransplantation faces challenges including immune rejection and zoonotic risks.

Purpose of the Study:

  • Review the rationale, sources, and preparation of pig islets for xenotransplantation.
  • Present progress in overcoming challenges for clinical application in type 1 diabetes.
  • Evaluate the safety and efficacy of pig islet xenotransplantation.

Main Methods:

  • Review of existing literature on pig islet isolation, preparation, and transplantation.
  • Analysis of clinical trial data for pig islet xenotransplantation in humans and non-human primates.

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  • Discussion of strategies to mitigate immune rejection and zoonotic risks, including genetic modification and encapsulation.

    • Main Results:

    • Pig islet xenotransplantation in non-human primates shows potential to reverse diabetes.
    • Clinical trials report no porcine endogenous retrovirus (PERV) transmission.
    • Significant reductions in severe hypoglycemia and exogenous insulin requirements observed.

    Conclusions:

    • Pig islets are a viable alternative to human islets for type 1 diabetes treatment.
    • Strategies for managing immune rejection and zoonotic risks are advancing.
    • Further research into donor pig factors (age, breed) is crucial for optimizing outcomes.