Revascularization of transplanted pancreatic islets and role of the transplantation site.

Revascularization of transplanted pancreatic islets and role of the transplantation site.
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DOI:
10.1155/2013/352315
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发表时间:
2013
影响因子:
--
通讯作者:
Shapiro AM
Shapiro AM
中科院分区:
其他
文献类型:
--
作者:
Pepper AR;Gala-Lopez B;Ziff O;Shapiro AM

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自从首次报道通过胰岛移植成功逆转高血糖以来,已经进行了大量的研究工作来阐明血管重建的过程以及移植部位对移植物功能和存活的影响。在分离过程中,固有的胰岛血管网络被破坏,导致移植后血管重建受损。因此,在某些情况下,大量移植的β细胞团在输注到门静脉(临床上最常用的移植部位)后急性死亡。随后,尽管大多数患者在移植后实现了胰岛素依赖性,但随着时间的推移,其中一部分患者重新开始少量补充外源性胰岛素。在此,这篇综述考虑了移植后胰岛血管重建的过程,其限制因素,以及改善这一关键步骤的潜在策略。此外,我们提供了替代移植部位的表征,分析了历史演变及其在实验和临床环境中对推进移植结果的作用。
Since the initial reporting of the successful reversal of hyperglycemia through the transplantation of pancreatic islets, significant research efforts have been conducted in elucidating the process of revascularization and the influence of engraftment site on graft function and survival. During the isolation process the intrinsic islet vascular networks are destroyed, leading to impaired revascularization after transplant. As a result, in some cases a significant quantity of the beta cell mass transplanted dies acutely following the infusion into the portal vein, the most clinically used site of engraftment. Subsequently, despite the majority of patients achieving insulin independence after transplant, a proportion of them recommence small, supplemental exogenous insulin over time. Herein, this review considers the process of islet revascularization after transplant, its limiting factors, and potential strategies to improve this critical step. Furthermore, we provide a characterization of alternative transplant sites, analyzing the historical evolution and their role towards advancing transplant outcomes in both the experimental and clinical settings.
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