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In a recent Commentary in Xenotransplantation , Philip O'Connell outlines the challenges of pig‐to‐human islet transplantation (Tx). His emphasis is on the prevention of the xenogeneic immune reaction [ 1 ]. In the present Commentary, we attempt to provide a road map toward clinical pig islet Tx. The success with human islet Tx achieved in Edmonton [ 2 ] has stimulated worldwide interest in the Tx of the islets of Langerhans. In view of the scarcity of human tissue, it will not, however, be possible to apply islet Tx on a large scale unless a ‘‘surrogate’’ insulin‐producing tissue is made available. Pig insulin was used for several decades to treat diabetic patients, and the structure of pig insulin is very similar to that of human insulin; thus porcine islets would offer an alternative. Experience with transplantation of pig islets to humans, and to non‐human primates Fetal porcine islets were transplanted into 10 diabetic renal transplant patients in Sweden in the early 1990s; all patients were given cyclosporine‐based immunosuppressive treatment [ 3 ]. The islets were injected into the portal vein in eight patients. Four of these patients excreted porcine C‐peptide for 200 to 400 days post‐Tx. In one
Xenotransplantation – Wiley
Published: Jul 1, 2003
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