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Clinical Considerations for RPE Cell Transplantation

  • Regenerative Medicine in Ophthalmology (D Myung, Section Editor)
  • Published:
Current Ophthalmology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Transplantation of retinal pigment epithelium (RPE) derived from either induced pluripotent stem cells (iPSCs) or embryonic stem cells (ESCs) is steadily progressing toward a clinical reality. This review explores various aspects of transplantation that will be relevant to clinical settings, including cellular composition, delivery techniques, and complications resulting from the surgical procedure.

Recent Findings

Animal model research and clinical trials are refining the methodology, surgical techniques, and minimization of complications for RPE transplantation. Cellular composition of RPE for delivery has evolved from cell suspensions to sheets of cells grown on synthetic substrates. Surgical techniques are evolving as well, where trans-retinal delivery of cells to the sub-retinal space can have complications such as retinal detachment, whereas trans-scleral techniques may minimize some of the issues. Finally, immune-based rejection of transplanted tissue is a potential problem where precision medicine has the potential to tailor an immunosuppressive regimen that is specific to the individual to provide the best outcome.

Summary

The optimization of cell transplantation to the eye is ongoing. From a clinical standpoint, many of the observed complications are readily treatable, but others require careful monitoring.

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Acknowledgements

Facilities and resources were provided by the VA Western New York Healthcare System to MHF. MHF is also a Research Biologist at the VA Western New York Healthcare System, Buffalo, NY.

Funding

This work was supported by grants R01 EY028553 (NIH/NEI), M2019108 (BrightFocus Foundation), I01 BX004695 (VA Merit/BLR&D Service), and the Carl Marshall and Mildred Almen Reeves Founation to MHF.

Author information

Author notes

  1. Brian Madow and Michael H. Farkas contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

    Mark Seraly, Brian Madow & Michael H. Farkas

  2. Ross Eye Institute, State University of New York, 1176 Main St., Buffalo, NY, USA

    Mark Seraly, Brian Madow & Michael H. Farkas

  3. Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

    Michael H. Farkas

  4. Research Service, VA Western New York Healthcare System, 3495 Bailey Ave., Building 20, Room 239, Buffalo, NY, 14215, USA

    Michael H. Farkas

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  1. Mark Seraly
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Corresponding authors

Correspondence to Brian Madow or Michael H. Farkas.

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Conflict of Interest

MHF is a co-inventor and patent holder (US 20180043034 A1) of an AAV-based gene therapy for PRPF31-associated retinitis pigmentosa. MS and BM have no conflicts of interest to declare.

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This article is part of the Topical Collection on Regenerative Medicine in Ophthalmology

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Seraly, M., Madow, B. & Farkas, M.H. Clinical Considerations for RPE Cell Transplantation. Curr Ophthalmol Rep 10, 42–47 (2022). https://doi.org/10.1007/s40135-022-00287-3

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  • DOI: https://doi.org/10.1007/s40135-022-00287-3

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