Report of clinical cases of human fetal pancreas transplantation

Following encouraging results of some experimental trials on fetal pancreatic tissue transplantation, we attempted the clinical application of such graft modality in 12 diabetic recipients; similar experience has been reported by Groth et al. and by Chastan et al. We employed two transplantation techniques: the intramuscular and intrahepatic via portal vein with transcutaneous catheterism. Immunosuppression was not performed in order to assess the actual immunogenicity of fetal pancreatic tissue, but it will be attempted in future recipients. Only one of the ten patients receiving intramuscular transplantation of fetal pancreatic fragments after 5 months is still showing an adequate glycemic control and sufficient blood C-peptide levels. In a second patient, 30 days after transplantation a significative reduction of insulin requirement was evident along with a fairly significative plasma C-peptide increase. In all remaining patients receiving intramuscular grafts, insulin requirement and blood C-peptide didn't show notable variations. In the second group of recipients (intrahepatic transplantation by means of transcutaneous catheterism via portal vein), one patient showed, 5 months after transplantation, an evident reduction of insulin requirement and plasma C-peptide levels in normal range, thus indicating fetal pancreas survival. In the second patient of the same group, the graft lost function after 4 months, probably for immune rejection.