Cell Transplant and Gene Therapy Institute, The Third Xiang Ya Hospital of Central South University, Changsha, China.
Xenotransplantation. 2010 May-Jun;17(3):207-14. doi: 10.1111/j.1399-3089.2010.00580.x.
Islet xeno-transplantation via the portal vein has been proposed as an alternative of islet allo-transplantation for treatment of type 1 diabetes. However, the precise hepatic capacity has not been addressed.
We mimicked cell transplantation by infusion of dogs with alginate/poly-1-lysine/alginate (APA) microbeads via either the portal vein (PV) or hepatic artery (HA). The maximal adaptable capacity for infused microbeads was evaluated by examination of vasculature, microvasculature, hepatic hemodynamics, portal vein, and hepatic artery pressures and liver function in the microbead recipient dogs.
PV but not HA dogs demonstrated elevated portal pressure during the infusion procedure in a dose-dependent manner. Four out of twelve PV dogs infused with 32,000 microbeads/kg developed acute liver infarction within 24 h after infusion with four of the remaining eight animals developing portal venous thrombosis within 24 h following infusion. All PV animals demonstrated abnormal alanine aminotransferase (ALT) values, and the extent and duration of increased ALT levels correlated with the increase in the number of microbeads infused. In contrast, HA animals infused with as many as 32,000 microbeads/kg had neither portal thrombosis nor abnormal liver function.
The capacity for intrahepatic cell infusion is finite and the intrahepatic artery may have a less hemodynamic interference impact on transplantation of cells into the liver when a larger volume of cells is required to achieve curable outcomes in both allo- and xeno-transplantation.
胰岛异种移植已被提议作为胰岛同种移植治疗 1 型糖尿病的替代方法。然而,确切的肝脏容量尚未得到解决。
我们通过门静脉(PV)或肝动脉(HA)输注藻酸盐/聚赖氨酸/藻酸盐(APA)微球来模拟细胞移植。通过检查血管、微血管、肝血流动力学、门静脉和肝动脉压以及微球受者狗的肝功能来评估输注微球的最大适应性容量。
PV 但不是 HA 狗在输注过程中以剂量依赖性方式表现出升高的门静脉压。在输注 32000 个微球/kg 后,12 只 PV 狗中有 4 只在 24 小时内发生急性肝梗死,其余 8 只中有 4 只在输注后 24 小时内发生门静脉血栓形成。所有 PV 动物均表现出异常丙氨酸氨基转移酶(ALT)值,并且 ALT 水平升高的程度和持续时间与输注的微球数量增加相关。相比之下,即使输注多达 32000 个微球/kg 的 HA 动物也没有门静脉血栓形成或肝功能异常。
肝内细胞输注的容量是有限的,当需要更大体积的细胞来实现同种和异种移植的可治愈结果时,肝内动脉可能对细胞移植到肝脏的血流动力学干扰影响较小。