Stagner John I, Rilo Horacio L, White Karen K
JOP. 2007 Sep 7;8(5):628-36.
The availability of islet transplantation is limited by both the number of donor pancreata and the number of islets required for successful transplantation. There is evidence that the liver presents a less than optimal environment for islets that contributes to short- and long-term beta cell destruction or failure.
It is our hypothesis that the pancreas is a suitable transplant site and may require fewer islets than standard sites such as the liver or kidney, and could lead to improvements in transplantation outcomes.
To test this hypothesis both a rodent and a canine model were used. Syngeneic rat islets were transplanted to the pancreas, liver, or kidney of Lewis rats. Fasting blood glucose levels were compared for three months as an index of islet function. Dogs received an islet autotransplant to a pancreatic remnant. Insulin and glucose concentrations were followed for six months.
In the rat, normoglycemia was maintained with 600 islets transplanted in the pancreas in contrast to the liver (3,200 islets) or kidney (1,000-2,000 islets). Dogs remained normoglycemic after receiving an intra-pancreatic islet transplant (mean 7,640+/-3,600 islets). There was no evidence of pancreatitis or nutritional deficiency in either species.
The pancreas should be considered as an islet transplant site. The pancreas is the native milieu for islets, and offers the advantage of requiring fewer islets than other conventional sites, thereby increasing the possibility that one donor pancreas may serve one or more recipients.
胰岛移植的可行性受到供体胰腺数量以及成功移植所需胰岛数量的限制。有证据表明，肝脏对胰岛而言并非最佳环境，这会导致胰岛β细胞在短期和长期内遭到破坏或功能衰竭。
我们的假设是，胰腺是一个合适的移植部位，与肝脏或肾脏等标准移植部位相比，可能所需的胰岛数量更少，并且可能会改善移植效果。
为验证这一假设，使用了啮齿动物和犬类模型。将同基因大鼠胰岛移植到Lewis大鼠的胰腺、肝脏或肾脏中。以三个月内的空腹血糖水平作为胰岛功能指标进行比较。给犬类进行胰岛自体移植到胰腺残端。随访六个月内的胰岛素和葡萄糖浓度。
在大鼠中，移植600个胰岛到胰腺可维持正常血糖水平，而移植到肝脏则需要3200个胰岛，移植到肾脏需要1000 - 2000个胰岛。犬类接受胰腺内胰岛移植后维持正常血糖水平（平均7640±3600个胰岛）。两种动物均未出现胰腺炎或营养缺乏的迹象。
应将胰腺视为胰岛移植部位。胰腺是胰岛的天然环境，与其他传统移植部位相比具有所需胰岛数量更少的优势，从而增加了一个供体胰腺可为一个或多个受体所用的可能性。
