Encapsulated Pancreatic Islet Transplantation Feasible

Microencapsulated pancreatic islet transplantation into two patients with type 1 diabetes is showing promising results.

As Dr. Riccardo Calafiore lead investigator stated, "since the transplanted islets are physically immunoprotected into microcapsules, the recipients will not require pharmacologic immunosuppression — whose long-term deleterious effects are only partially known."

After years of preclinical studies, as many as 600,000 microencapsulated islets initially isolated from single-donor pancreases were grafted into two patients on intensive insulin therapy, Dr. Calafiore and colleagues at the University of Perugia report.

So far, the procedure appears to be "simple, noninvasive, painless and devoid of side effects," he continued. Although the patients still require insulin, one has shown a reduction in GHb and frequent (four per week) severe hypoglycemic episodes have disappeared.

The researchers note that the Italian Ministry of Health granted permission to recruit 10 patients for this study, and adjustments to the procedure in the remaining subjects may further improve clinical results.

Dr. Calafiore added that "the restricted availability of cadaveric human donor pancreases for islet retrieval makes it almost inevitable future use of non-human tissue or human engineered/non-engineered, or finally multi/pluripotent stem cells as a resource for insulin producing cells."

Even in these instances, he concluded, "the special immunobarrier provided by the capsules could help obviate (the) use of immunosuppressive agents."

Diabetes Care 2006;29:137-138.