Vascularized islet-cell transplantation in miniature swine. I. Preparation of vascularized islet kidneys
Whereas clinical pancreatic transplantation has been highly successful in correcting the hyperglycemia of insulin-dependent diabetes mellitus (type 1), the results of islet transplantation have been disappointing. This discrepancy may be because of, at least in part, nonspecific loss of islets durin...
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| Veröffentlicht in: | Transplantation 2002-11, Vol.74 (9), p.1223-1230 |
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| creator | KUMAGAI, Naoki O'NEIL, John J SACHS, David H YAMADA, Kazuhiko BARTH, Rolf N LAMATTINA, John C UTSUGI, Ryu MORAN, Shannon G YAMAMOTO, Shin VAGEFI, Parsia A KITAMURA, Hiroshi KAMANO, Chisako |
| description | Whereas clinical pancreatic transplantation has been highly successful in correcting the hyperglycemia of insulin-dependent diabetes mellitus (type 1), the results of islet transplantation have been disappointing. This discrepancy may be because of, at least in part, nonspecific loss of islets during the time required for revascularization. To test this hypothesis, we have designed composite kidney grafts containing vascularized autologous islets that can be used to compare the engraftment potential of vascularized versus nonvascularized islet tissue.
(1) Islet-cell isolation: miniature swine underwent either partial pancreatectomy to isolate autologous islets or total pancreatectomy to isolate minor antigen-mismatched islets. Islets were purified from excised pancreatic tissue by enzymatic digestion and discontinuous density gradient purification. Isolated islets were cultured for 3 days before transplant. (2) Creation of vascularized islet kidneys (IK): autologous islets alone (n=6), minor-mismatched islets alone (n=3), and minor-mismatched islets plus simultaneous autologous thymic tissue (n=3) were transplanted beneath the renal capsule of juvenile miniature swine. Minor antigen-mismatched islets were also transplanted into both the vascularized thymic graft of a thymokidney (to produce a thymo-islet kidney [TIK]) and the contralateral native kidney (n=3) and both the host thymus and beneath the renal capsule (n=2). All recipients receiving minor-mismatched islets were treated with a 12-day intravenous (IV) course of either cyclosporine A (CsA) at 10 mg/kg per day or FK506 at 0.15 mg/kg per day. (3) Assessment of Function: to evaluate the function of the transplanted islets, three animals bearing TIK and IK underwent total pancreatectomy 3 months following islet transplantation.
(1) Islet-cell yields: an average of 254,960+/-51,879 (4,452+/-932 islet equivalents [IEQ]/gram of pancreas) and 374,410+/-9,548 (4,183+/-721 IEQ/gram of pancreas) viable islets were obtained by partial pancreatectomy and complete pancreatectomy, respectively. (2) Creation of IK: autologous islets engrafted indefinitely, whereas recipients of minor-mismatched islets alone rejected the islets within 2 months. However, when minor-mismatched islets were implanted into both the thymokidney and the contralateral kidney of animals bearing a thymokidney, the islets engrafted indefinitely in both sites (>3 months). Simultaneous implantation of islets into the host thymus and under the |
| doi_str_mv | 10.1097/00007890-200211150-00005 |
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(1) Islet-cell isolation: miniature swine underwent either partial pancreatectomy to isolate autologous islets or total pancreatectomy to isolate minor antigen-mismatched islets. Islets were purified from excised pancreatic tissue by enzymatic digestion and discontinuous density gradient purification. Isolated islets were cultured for 3 days before transplant. (2) Creation of vascularized islet kidneys (IK): autologous islets alone (n=6), minor-mismatched islets alone (n=3), and minor-mismatched islets plus simultaneous autologous thymic tissue (n=3) were transplanted beneath the renal capsule of juvenile miniature swine. Minor antigen-mismatched islets were also transplanted into both the vascularized thymic graft of a thymokidney (to produce a thymo-islet kidney [TIK]) and the contralateral native kidney (n=3) and both the host thymus and beneath the renal capsule (n=2). All recipients receiving minor-mismatched islets were treated with a 12-day intravenous (IV) course of either cyclosporine A (CsA) at 10 mg/kg per day or FK506 at 0.15 mg/kg per day. (3) Assessment of Function: to evaluate the function of the transplanted islets, three animals bearing TIK and IK underwent total pancreatectomy 3 months following islet transplantation.
(1) Islet-cell yields: an average of 254,960+/-51,879 (4,452+/-932 islet equivalents [IEQ]/gram of pancreas) and 374,410+/-9,548 (4,183+/-721 IEQ/gram of pancreas) viable islets were obtained by partial pancreatectomy and complete pancreatectomy, respectively. (2) Creation of IK: autologous islets engrafted indefinitely, whereas recipients of minor-mismatched islets alone rejected the islets within 2 months. However, when minor-mismatched islets were implanted into both the thymokidney and the contralateral kidney of animals bearing a thymokidney, the islets engrafted indefinitely in both sites (>3 months). Simultaneous implantation of islets into the host thymus and under the renal capsule also led to permanent engraftment of minor-mismatched islets. (3) Function of vascularized islets: three animals with both a TIK and an IK in place for 3 months underwent total pancreatectomy. All three animals maintained normoglycemia thereafter. In two of these animals, the IKs were removed 2 months after the pancreatectomy, and in both cases normoglycemia was maintained thereafter by the TIK.
The implantation of islets beneath the autologous renal capsule permitted the establishment of a vascular supply and thereby supported normal islet-cell growth and function. The presence of thymic tissue beneath the autologous renal capsule facilitated the engraftment of minor-mismatched islets, and such grafts achieved results similar to autologous islet transplants. Therefore, the ability to create vascularized islet grafts may provide a strategy for successful islet transplantation across allogeneic and potentially across xenogeneic barriers.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/00007890-200211150-00005</identifier><identifier>PMID: 12451257</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Animals ; Biological and medical sciences ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Rejection ; Histocompatibility ; Insulin - biosynthesis ; Islets of Langerhans - blood supply ; Islets of Langerhans - metabolism ; Islets of Langerhans - surgery ; Islets of Langerhans Transplantation ; Kidney - surgery ; Pancreatectomy ; Postoperative Period ; Surgically-Created Structures ; Swine ; Swine, Miniature ; Thymus Gland - blood supply ; Thymus Gland - surgery ; Thymus Gland - transplantation ; Tissue, organ and graft immunology ; Transplantation, Heterotopic</subject><ispartof>Transplantation, 2002-11, Vol.74 (9), p.1223-1230</ispartof><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c488t-48928a2e2039101e30b57b0056adf3abccccf3861bf431541ddda74ef6baa54e3</citedby><cites>FETCH-LOGICAL-c488t-48928a2e2039101e30b57b0056adf3abccccf3861bf431541ddda74ef6baa54e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14027423$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12451257$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KUMAGAI, Naoki</creatorcontrib><creatorcontrib>O'NEIL, John J</creatorcontrib><creatorcontrib>SACHS, David H</creatorcontrib><creatorcontrib>YAMADA, Kazuhiko</creatorcontrib><creatorcontrib>BARTH, Rolf N</creatorcontrib><creatorcontrib>LAMATTINA, John C</creatorcontrib><creatorcontrib>UTSUGI, Ryu</creatorcontrib><creatorcontrib>MORAN, Shannon G</creatorcontrib><creatorcontrib>YAMAMOTO, Shin</creatorcontrib><creatorcontrib>VAGEFI, Parsia A</creatorcontrib><creatorcontrib>KITAMURA, Hiroshi</creatorcontrib><creatorcontrib>KAMANO, Chisako</creatorcontrib><title>Vascularized islet-cell transplantation in miniature swine. I. Preparation of vascularized islet kidneys</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Whereas clinical pancreatic transplantation has been highly successful in correcting the hyperglycemia of insulin-dependent diabetes mellitus (type 1), the results of islet transplantation have been disappointing. This discrepancy may be because of, at least in part, nonspecific loss of islets during the time required for revascularization. To test this hypothesis, we have designed composite kidney grafts containing vascularized autologous islets that can be used to compare the engraftment potential of vascularized versus nonvascularized islet tissue.
(1) Islet-cell isolation: miniature swine underwent either partial pancreatectomy to isolate autologous islets or total pancreatectomy to isolate minor antigen-mismatched islets. Islets were purified from excised pancreatic tissue by enzymatic digestion and discontinuous density gradient purification. Isolated islets were cultured for 3 days before transplant. (2) Creation of vascularized islet kidneys (IK): autologous islets alone (n=6), minor-mismatched islets alone (n=3), and minor-mismatched islets plus simultaneous autologous thymic tissue (n=3) were transplanted beneath the renal capsule of juvenile miniature swine. Minor antigen-mismatched islets were also transplanted into both the vascularized thymic graft of a thymokidney (to produce a thymo-islet kidney [TIK]) and the contralateral native kidney (n=3) and both the host thymus and beneath the renal capsule (n=2). All recipients receiving minor-mismatched islets were treated with a 12-day intravenous (IV) course of either cyclosporine A (CsA) at 10 mg/kg per day or FK506 at 0.15 mg/kg per day. (3) Assessment of Function: to evaluate the function of the transplanted islets, three animals bearing TIK and IK underwent total pancreatectomy 3 months following islet transplantation.
(1) Islet-cell yields: an average of 254,960+/-51,879 (4,452+/-932 islet equivalents [IEQ]/gram of pancreas) and 374,410+/-9,548 (4,183+/-721 IEQ/gram of pancreas) viable islets were obtained by partial pancreatectomy and complete pancreatectomy, respectively. (2) Creation of IK: autologous islets engrafted indefinitely, whereas recipients of minor-mismatched islets alone rejected the islets within 2 months. However, when minor-mismatched islets were implanted into both the thymokidney and the contralateral kidney of animals bearing a thymokidney, the islets engrafted indefinitely in both sites (>3 months). Simultaneous implantation of islets into the host thymus and under the renal capsule also led to permanent engraftment of minor-mismatched islets. (3) Function of vascularized islets: three animals with both a TIK and an IK in place for 3 months underwent total pancreatectomy. All three animals maintained normoglycemia thereafter. In two of these animals, the IKs were removed 2 months after the pancreatectomy, and in both cases normoglycemia was maintained thereafter by the TIK.
The implantation of islets beneath the autologous renal capsule permitted the establishment of a vascular supply and thereby supported normal islet-cell growth and function. The presence of thymic tissue beneath the autologous renal capsule facilitated the engraftment of minor-mismatched islets, and such grafts achieved results similar to autologous islet transplants. Therefore, the ability to create vascularized islet grafts may provide a strategy for successful islet transplantation across allogeneic and potentially across xenogeneic barriers.</description><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Rejection</subject><subject>Histocompatibility</subject><subject>Insulin - biosynthesis</subject><subject>Islets of Langerhans - blood supply</subject><subject>Islets of Langerhans - metabolism</subject><subject>Islets of Langerhans - surgery</subject><subject>Islets of Langerhans Transplantation</subject><subject>Kidney - surgery</subject><subject>Pancreatectomy</subject><subject>Postoperative Period</subject><subject>Surgically-Created Structures</subject><subject>Swine</subject><subject>Swine, Miniature</subject><subject>Thymus Gland - blood supply</subject><subject>Thymus Gland - surgery</subject><subject>Thymus Gland - transplantation</subject><subject>Tissue, organ and graft immunology</subject><subject>Transplantation, Heterotopic</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkclOwzAQhi0EoqXwCsgXuKV4vMTuEVUslSrBAbhGk8QRhizFTkDl6UlooQcOzGWk0Tfb_xNCgU2BzfQF60ObGYs4YxwAFIuGktojY1BCRjEzbJ-MGZMQgRB6RI5CeBkIofUhGQGXCrjSY_L8hCHrSvTu0-bUhdK2UWbLkrYe67AqsW6xdU1NXU0rVztsO29p-HC1ndLFlN57u0K_QZqCvv-ZRl9dXtt1OCYHBZbBnmzzhDxeXz3Mb6Pl3c1ifrmMMmlMG0kz4wa55UzMgIEVLFU67Q-PMS8EplkfhTAxpIUUoCTkeY5a2iJOEZW0YkLON3NXvnnrbGiTyoXhI6xt04VEcw1Gx_G_YE8J0FL1oNmAmW9C8LZIVt5V6NcJsGSwI_mxI_m147s0tJ5ud3RpZfNd41b_HjjbAr1wWBa96JkLO04yriUX4gs4z5Pg</recordid><startdate>20021115</startdate><enddate>20021115</enddate><creator>KUMAGAI, Naoki</creator><creator>O'NEIL, John J</creator><creator>SACHS, David H</creator><creator>YAMADA, Kazuhiko</creator><creator>BARTH, Rolf N</creator><creator>LAMATTINA, John C</creator><creator>UTSUGI, Ryu</creator><creator>MORAN, Shannon G</creator><creator>YAMAMOTO, Shin</creator><creator>VAGEFI, Parsia A</creator><creator>KITAMURA, Hiroshi</creator><creator>KAMANO, Chisako</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20021115</creationdate><title>Vascularized islet-cell transplantation in miniature swine. I. Preparation of vascularized islet kidneys</title><author>KUMAGAI, Naoki ; O'NEIL, John J ; SACHS, David H ; YAMADA, Kazuhiko ; BARTH, Rolf N ; LAMATTINA, John C ; UTSUGI, Ryu ; MORAN, Shannon G ; YAMAMOTO, Shin ; VAGEFI, Parsia A ; KITAMURA, Hiroshi ; KAMANO, Chisako</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c488t-48928a2e2039101e30b57b0056adf3abccccf3861bf431541ddda74ef6baa54e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Rejection</topic><topic>Histocompatibility</topic><topic>Insulin - biosynthesis</topic><topic>Islets of Langerhans - blood supply</topic><topic>Islets of Langerhans - metabolism</topic><topic>Islets of Langerhans - surgery</topic><topic>Islets of Langerhans Transplantation</topic><topic>Kidney - surgery</topic><topic>Pancreatectomy</topic><topic>Postoperative Period</topic><topic>Surgically-Created Structures</topic><topic>Swine</topic><topic>Swine, Miniature</topic><topic>Thymus Gland - blood supply</topic><topic>Thymus Gland - surgery</topic><topic>Thymus Gland - transplantation</topic><topic>Tissue, organ and graft immunology</topic><topic>Transplantation, Heterotopic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KUMAGAI, Naoki</creatorcontrib><creatorcontrib>O'NEIL, John J</creatorcontrib><creatorcontrib>SACHS, David H</creatorcontrib><creatorcontrib>YAMADA, Kazuhiko</creatorcontrib><creatorcontrib>BARTH, Rolf N</creatorcontrib><creatorcontrib>LAMATTINA, John C</creatorcontrib><creatorcontrib>UTSUGI, Ryu</creatorcontrib><creatorcontrib>MORAN, Shannon G</creatorcontrib><creatorcontrib>YAMAMOTO, Shin</creatorcontrib><creatorcontrib>VAGEFI, Parsia A</creatorcontrib><creatorcontrib>KITAMURA, Hiroshi</creatorcontrib><creatorcontrib>KAMANO, Chisako</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KUMAGAI, Naoki</au><au>O'NEIL, John J</au><au>SACHS, David H</au><au>YAMADA, Kazuhiko</au><au>BARTH, Rolf N</au><au>LAMATTINA, John C</au><au>UTSUGI, Ryu</au><au>MORAN, Shannon G</au><au>YAMAMOTO, Shin</au><au>VAGEFI, Parsia A</au><au>KITAMURA, Hiroshi</au><au>KAMANO, Chisako</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vascularized islet-cell transplantation in miniature swine. I. Preparation of vascularized islet kidneys</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2002-11-15</date><risdate>2002</risdate><volume>74</volume><issue>9</issue><spage>1223</spage><epage>1230</epage><pages>1223-1230</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Whereas clinical pancreatic transplantation has been highly successful in correcting the hyperglycemia of insulin-dependent diabetes mellitus (type 1), the results of islet transplantation have been disappointing. This discrepancy may be because of, at least in part, nonspecific loss of islets during the time required for revascularization. To test this hypothesis, we have designed composite kidney grafts containing vascularized autologous islets that can be used to compare the engraftment potential of vascularized versus nonvascularized islet tissue.
(1) Islet-cell isolation: miniature swine underwent either partial pancreatectomy to isolate autologous islets or total pancreatectomy to isolate minor antigen-mismatched islets. Islets were purified from excised pancreatic tissue by enzymatic digestion and discontinuous density gradient purification. Isolated islets were cultured for 3 days before transplant. (2) Creation of vascularized islet kidneys (IK): autologous islets alone (n=6), minor-mismatched islets alone (n=3), and minor-mismatched islets plus simultaneous autologous thymic tissue (n=3) were transplanted beneath the renal capsule of juvenile miniature swine. Minor antigen-mismatched islets were also transplanted into both the vascularized thymic graft of a thymokidney (to produce a thymo-islet kidney [TIK]) and the contralateral native kidney (n=3) and both the host thymus and beneath the renal capsule (n=2). All recipients receiving minor-mismatched islets were treated with a 12-day intravenous (IV) course of either cyclosporine A (CsA) at 10 mg/kg per day or FK506 at 0.15 mg/kg per day. (3) Assessment of Function: to evaluate the function of the transplanted islets, three animals bearing TIK and IK underwent total pancreatectomy 3 months following islet transplantation.
(1) Islet-cell yields: an average of 254,960+/-51,879 (4,452+/-932 islet equivalents [IEQ]/gram of pancreas) and 374,410+/-9,548 (4,183+/-721 IEQ/gram of pancreas) viable islets were obtained by partial pancreatectomy and complete pancreatectomy, respectively. (2) Creation of IK: autologous islets engrafted indefinitely, whereas recipients of minor-mismatched islets alone rejected the islets within 2 months. However, when minor-mismatched islets were implanted into both the thymokidney and the contralateral kidney of animals bearing a thymokidney, the islets engrafted indefinitely in both sites (>3 months). Simultaneous implantation of islets into the host thymus and under the renal capsule also led to permanent engraftment of minor-mismatched islets. (3) Function of vascularized islets: three animals with both a TIK and an IK in place for 3 months underwent total pancreatectomy. All three animals maintained normoglycemia thereafter. In two of these animals, the IKs were removed 2 months after the pancreatectomy, and in both cases normoglycemia was maintained thereafter by the TIK.
The implantation of islets beneath the autologous renal capsule permitted the establishment of a vascular supply and thereby supported normal islet-cell growth and function. The presence of thymic tissue beneath the autologous renal capsule facilitated the engraftment of minor-mismatched islets, and such grafts achieved results similar to autologous islet transplants. Therefore, the ability to create vascularized islet grafts may provide a strategy for successful islet transplantation across allogeneic and potentially across xenogeneic barriers.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>12451257</pmid><doi>10.1097/00007890-200211150-00005</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Animals Biological and medical sciences Fundamental and applied biological sciences. Psychology Fundamental immunology Graft Rejection Histocompatibility Insulin - biosynthesis Islets of Langerhans - blood supply Islets of Langerhans - metabolism Islets of Langerhans - surgery Islets of Langerhans Transplantation Kidney - surgery Pancreatectomy Postoperative Period Surgically-Created Structures Swine Swine, Miniature Thymus Gland - blood supply Thymus Gland - surgery Thymus Gland - transplantation Tissue, organ and graft immunology Transplantation, Heterotopic |
| title | Vascularized islet-cell transplantation in miniature swine. I. Preparation of vascularized islet kidneys |
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