Transplantation of organ-cultured fetal pancreas: experimental studies and potential clinical application in diabetes mellitus.

Abstract

AbstractTransplantation of organ‐cultured fetal islets of Langer‐hans may be one way of overcoming the dual difficulties of finding a suitable source of tissue and controlling graft rejection. Experiments in mice have clearly shown that fetal pancreas is an excellent source of islets. Tissue from one donor can be used to treat one or more recipients and provides excellent control of drug‐induced diabetes, including prevention of diabetic renal microangiopathy. The fetal islets display selective survival in vitro and organ culture can be used to obtain large amounts of tissue for transplantation. In addition, growth in “normoglycemic” media results in functional maturation of the fetal tissue.Culture conditions can be modified to eliminate from the putative graft immunogenic “passenger leukocytes,” the cells responsible for initiating graft rejection. Such immunogenic cell—depleted grafts can be transplanted across histocompatibility barriers without the need for recipient immunosuppression.Fetal human pancreas shares many properties in common with fetal mouse pancreas. Continuing growth and differentiation occur in vitro and following xenotransplantation into athymic mice. However, fetal human pancreas is frequently damaged by ischemia before it can be used, and also appears to be more susceptible to oxygen toxicity than is fetal mouse pancreas. Nevertheless, when fresh human tissue is available, it may be a suitable source of islets for transplantation in type I diabetics.