Cell transplantation and diabetes: New sites, n...( Tampa Fla. (Jan. 21 2009) Early att...),Health

Tampa, Fla. (Jan. 21, 2009) Early attempts at islet cell transplantation to treat diabetes date to the nineteenth century, decades before the discovery of insulin in the 1930s. In recent years, research has focused on the anatomical sites best suited for hosting transplanted islet cells. Experimental sites have included the spleen, liver, peritoneal cavity, omentum, subcutaneous tissues and gastric submucosa. However, many transplant attempts at a variety of anatomical sites have failed because of a variety of complications.

While transplanting islet cells into the liver is current practice, improvements in biomedical devices have improved the overall success rates of islet transplantation. Recent advances in islet transplantation are discussed in the January issue of Cell Transplantation (Vol. 17 No.9).

A review evaluating both anatomical site choice for islet cell transplantation and an ideal source of islet cells was the focus of a report by Dr. Dirk Van der Windt and colleagues at the Thomas E. Starzl Transplantation Institute at the University of Pittsburgh Medical Center. They concluded that transplantation into the liver "may not provide the conditions favoring optimum islet survival."

"Islet transplantation into the portal vein is current clinical practice," said Van der Windt. "However, this site has several characteristics that can hamper islet engraftment and survival."

According to Van der Windt, low oxygen tension and immune and inflammatory responses are among factors that can account for islet cell loss soon after transplantation. Thus, alternative anatomical sites for islet transplantation, sites offering maximum engraftment potential, the efficacious use of insulin and patient safety, are needed.

"The most physiological - and therefore perhaps most supportive, microenvironment for islets - is the pancreas itself," said Va
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