Valdés-González R A, White D J G, Dorantes L M, Terán L, Garibay-Nieto G N, Bracho-Blanchet E, Dávila-Pérez R, Evia-Viscarra L, Ormsby C E, Ayala-Sumuano J T, Silva-Torres M L, Ramírez-González B
Department of Surgery, Faculty of Medicine, National Autonomous University of Mexico, Children's Hospital of Mexico, Federico Gomez, México City, Mexico.
Clin Transplant. 2007 May-Jun;21(3):352-7. doi: 10.1111/j.1399-0012.2007.00648.x.
In order to alleviate the shortage of human donors, the use of porcine islets of Langerhans for xenotransplantation in diabetic patients has been proposed as a solution. To overcome rejection, we have developed a procedure for protecting the islets by combining them with Sertoli cells and placing them in a novel subcutaneous device, that generates an autologous collagen covering. A type 1 diabetic woman was closely monitored for 10 months, and then transplanted in two devices with two months of difference and a third time after 22 months. Here we present a three-yr follow-up. The close monitoring induced a rapid decrease in exogenous insulin requirements, which stabilized between 19 and 28 IU/d for nine months. After transplantation, the requirements reduced further to below 6 IU/d and for some weeks she was insulin free. Glycosylated hemoglobin levels decreased concomitantly. Porcine insulin could be detected in the serum after a glucose challenge and insulin positive cells inside a removed device after two yr. No complications have arisen and no porcine endogenous retrovirus infection has been detected through PCR and RT-PCR. This case demonstrates the feasibility of using the xenotransplantation of porcine cells to alleviate metabolic complications and insulin requirements in type 1 diabetic patients.
