Reduction of early graft loss after intraportal porcine islet transplantation in monkeys

摘要: Background Pig islets constitute a possible resolution to the shortage of human for transplantation. After intraportal infusion porcine in primates, many are lost through what has been termed instant blood-mediated inflammatory reaction (IBMIR). We report on our experience with IBMIR. Methods Ten monkeys underwent islet Immunosuppressive therapy was conventional agents (n=3) or based costimulation blockade (n=7). Treatment specific IBMIR administered eight monkeys; two additional received no such (group 1). Cobra venom factor completely inhibited complement activity four 2) and dextran sulfate provided anticoagulation 3). Islet graft function monitored by following blood glucose, insulin requirement, C-peptide values. Results In that neither cobra nor 1), there rapid destruction indicated severe hypoglycemia need dextrose infusion; levels were initially low further reduction occurred within first five days. both groups 2 3, significantly less some reversal diabetes. However, when 40,000 IEQ/kg infused, normoglycemia days, but 80,000 infused one case, more persistent. observed even normal range healthy nondiabetic pigs, these not sufficient maintain monkeys. Conclusions Although pretransplantation depletion reduces xenograft loss significantly, alone is prevent