From Langerhans Islets to Pancreas Transplantation over the past 30 years: A Review with Personal Contributions

Abstract

Organ, tissue and cell banking is currently an important method used to prevent death of cells in replacement transplantation therapy. From 1975 to 1985 the author performed experimental transplantations of islets isolated by collagenase digestion through injection into the liver through the portal vein, or by transplantation of minced neonatal pancreases under the renal capsule of alloxan or spreptozotocin into severely chronic diabetic rats and mice. Seventy of the 256 transplanted rats and mice were cured for 1 year, i.e. one-third of their life span, at the 3rd to 15th inbreeding and only 2 weeks of immunosuppression by azathioprine or cyclosporin A. The author compares his results with those achieved later with diabetic patients by whole pancreas transplantation, including prevention of diabetic renal and ocular complications, infertility, health of progeny of cured rats, and slow rejection and possibility of cure by repeated transplantation. He welcomes the return to islet transplantation, and possibly also of immunologically tolerant pancreatic stem cell transplantation, or transplantation of subcutaneous fibroblasts, transfected with a complex insulin gene, which will produce adequate insulin to prevent hyperglycemia, as does hepatic pyruvate kinase from an insulin analog, a therapy that will not need permanent immunosuppression.