Pancreatic islet transplantation using the nonhuman primate (rhesus) model predicts that the portal vein is superior to the celiac artery as the islet infusion site.

Published

Journal Article

We've established a nonhuman primate islet allotransplant model to address questions such as whether transplanting islets into the gut's arterial system would more safely and as effectively support long-term islet allograft survival compared with the traditional portal vein approach. We reasoned that islets make up <2% of pancreatic cell mass but consume an estimated 20% of arterial blood flow, suggesting an advantage for the arterial site. Access to the arterial system is also easier and safer than the portal system. Pancreatectomized rhesus macaques were transplanted with allogeneic islets infused into either the portal vein (n = 6) or the celiac artery (n = 4). To prevent rejection, primates were given daclizumab, tacrolimus, and rapamycin. In five of six portal vein experiments, animals achieved normoglycemia without exogenous insulin. In contrast, none of the animals given intra-arterial islets showed even transient insulin independence (P = 0.048). Two of the latter animals received a second islet transplant, this time to the portal system, and both achieved insulin independence. Thus, intraportal islet transplantation under conventional immunosuppression is feasible in primates and can result in long-term insulin independence when adequate immunosuppression is maintained. Arterial islet injection, however, does not appear to be a viable islet transplantation technique.

Full Text

Duke Authors

Cited Authors

  • Hirshberg, B; Montgomery, S; Wysoki, MG; Xu, H; Tadaki, D; Lee, J; Hines, K; Gaglia, J; Patterson, N; Leconte, J; Hale, D; Chang, R; Kirk, AD; Harlan, DM

Published Date

  • July 2002

Published In

Volume / Issue

  • 51 / 7

Start / End Page

  • 2135 - 2140

PubMed ID

  • 12086943

Pubmed Central ID

  • 12086943

International Standard Serial Number (ISSN)

  • 0012-1797

Digital Object Identifier (DOI)

  • 10.2337/diabetes.51.7.2135

Language

  • eng

Conference Location

  • United States