Porcine islet xenotransplantation utilizing a vascularized bioartificial pancreas

Successful pancreas/islet transplantation restores normal glucose metabolism in patients with insulin dependent diabetes mellitus (IDDM) but requires chronic immunosuppression which is associated with morbidity and mortality. Immune exclusion devices containing pancreatic islets (bioartificial pancreas) are designed to provide glycemic control without immunosuppression. The immune exclusion is achieved by separating islets from the host by semipermeable membranes. Small molecules such as glucose, insulin and nutrients pass through, whereas immune lymphocytes and immunoglobulins are excluded by the membrane and unable to cause destruction of the islets. Use of xenogeneic islets (i.e., porcine islets) in the device also circumvents the shortage of human donor organs. This report provides a brief summary of our experience with vascularized bioartificial pancreas (VBAP) containing allogeneic and xenogeneic islets for treatment of experimental diabetes in dogs and describes our plans for a clinical trial of the VBAP in patients with IDDM.