Pig-to-Primate Islet Xenotransplantation: Past, Present, and Future

• Main Authors: Zhengzhao Liu, Wenbao Hu, Tian He, Yifan Dai, Hidetaka Hara, Rita Bottino, David K. C. Cooper, Zhiming Cai, Lisha Mou Ph.D.
• Format: Article
• Language: English
• Published: SAGE Publishing 2017-06-01
• Series: Cell Transplantation
• Online Access: https://doi.org/10.3727/096368917X694859

Islet allotransplantation results in increasing success in treating type 1 diabetes, but the shortage of deceased human donor pancreata limits progress. Islet xenotransplantation, using pigs as a source of islets, is a promising approach to overcome this limitation. The greatest obstacle is the primate immune/inflammatory response to the porcine (pig) islets, which may take the form of rapid early graft rejection (the instant blood-mediated inflammatory reaction) or T-cell-mediated rejection. These problems are being resolved by the genetic engineering of the source pigs combined with improved immunosuppressive therapy. The results of pig-to-diabetic nonhuman primate islet xenotransplantation are steadily improving, with insulin independence being achieved for periods >1 year. An alternative approach is to isolate islets within a micro- or macroencapsulation device aimed at protecting them from the human recipient's immune response. Clinical trials using this approach are currently underway. This review focuses on the major aspects of pig-to-primate islet xenotransplantation and its potential for treatment of type 1 diabetes.