Endoscopic gastric submucosal transplantation of islets (ENDO-STI): Technique and initial results in diabetic pigs

G. J. Echeverri, K. McGrath, R. Bottino, H. Hara, E. M. Dons, D. J. Van Der Windt, B. Ekser, A. Casu, S. Houser, M. Ezzelarab, R. Wagner, M. Trucco, F. G. Lakkis, D. K C Cooper

Research output: Contribution to journalArticle

Abstract

The results of transplantation of human donor islets into the portal vein (PV) in patients with diabetes are encouraging. However, there are complications, for example, hemorrhage, thrombosis and an immediate loss of islets through the 'instant blood-mediated inflammatory reaction' (IBMIR). The gastric submucosal space (GSMS) offers potential advantages. Islets were isolated from adult pigs. Recipient pigs were made diabetic by streptozotocin. Donor islets were injected into the GSMS through a laparotomy (Group 1A, n = 4) or endoscopically (Group 1B, n = 8) or into the PV through a laparotomy (Group 2, n = 3). The pigs were followed for a maximum of 28 days. Monitoring of C-peptide in Group 1 indicated that there was minimal immediate loss of islets whereas in Group 2 there was considerable loss from IBMIR. In Group 1, there were significant reductions in mean blood glucose and mean exogenous insulin requirement between pretransplantation and 20 days posttransplantation. In Group 2, there was no significant reduction in either parameter. Insulin-positive cells were seen in the GSMS in Group 1, but not in the liver in Group 2. Endoscopic gastric submucosal transplantation of islets (ENDO-STI) offers a minimally invasive and quick approach to islet transplantation, avoids IBMIR and warrants further exploration.

Original languageEnglish
Pages (from-to)2485-2496
Number of pages12
JournalAmerican Journal of Transplantation
Volume9
Issue number11
DOIs
Publication statusPublished - Nov 2009

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Keywords

  • Endoscopy
  • Gastric submucosal space
  • Islets
  • Pig
  • Portal vein
  • Transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Echeverri, G. J., McGrath, K., Bottino, R., Hara, H., Dons, E. M., Van Der Windt, D. J., Ekser, B., Casu, A., Houser, S., Ezzelarab, M., Wagner, R., Trucco, M., Lakkis, F. G., & Cooper, D. K. C. (2009). Endoscopic gastric submucosal transplantation of islets (ENDO-STI): Technique and initial results in diabetic pigs. American Journal of Transplantation, 9(11), 2485-2496. https://doi.org/10.1111/j.1600-6143.2009.02815.x