Diabetology Unit, Niguarda Hospital, Milan, Italy.
Eur Rev Med Pharmacol Sci. 2018 Mar;22(6):1731-1736. doi: 10.26355/eurrev_201803_14588.
Alternative sites to the liver for islet transplantation have been studied for a long time. Intramuscular islet transplantation appears to be an alternative site to the liver because of the ease of access. First islet autotransplantations were reported in patients after total pancreatectomies. The transplanted islets showed a proper revascularization and their function was observed for up to 2 years after the implant. However, only a few cases of autotransplantation and no allotransplantation have been performed. The aim of this study was to verify the feasibility of islet allotransplantation into muscles.
In four patients affected by type 1 diabetes mellitus in which liver islet allotransplantation was contraindicated, human islets were transplanted into patients' arm muscle with local anesthesia.
The surgery was minimally invasive, without complications. In one patient a moderate local inflammatory reaction was observed at the site of the implant, which resolved spontaneously within 4 days. Islet graft function was observed after transplantation in all patients, but it progressively disappeared in 3 out 4 patients within a short time.
In this first ever-reported intramuscular pancreatic islet allotransplantation, the procedure appears feasible but new strategies must be envisaged to significantly improve islet engraftment and the long-term graft function.
人们长期以来一直在研究胰岛移植的肝脏替代部位。由于易于接近，肌肉内胰岛移植似乎是肝脏的替代部位。首例胰岛自体移植是在全胰腺切除术后的患者中报告的。移植的胰岛显示出适当的再血管化，并且在植入后长达 2 年内观察到其功能。然而，仅进行了少数自体移植，而没有进行同种异体移植。本研究的目的是验证将胰岛同种异体移植到肌肉中的可行性。
在 4 名患有 1 型糖尿病且肝胰岛同种异体移植禁忌的患者中，在局部麻醉下将人胰岛移植到患者的手臂肌肉中。
手术微创，无并发症。在一名患者中，在植入部位观察到中度局部炎症反应，该反应在 4 天内自发消退。在所有患者中均观察到胰岛移植物功能，但在 4 名患者中的 3 名中，在短时间内逐渐消失。
在首次报道的肌肉内胰腺胰岛同种异体移植中，该手术似乎可行，但必须设想新的策略来显著改善胰岛移植物的植入和长期移植物功能。
