Detection of pancreatic islet tissue following islet allotransplantation in man.
Detection of pancreatic islet tissue following islet allotransplantation in man.
复制标题
人类胰岛同种异体移植后胰岛组织的检测。
DOI：
10.1097/00007890-199112000-00026
复制
发表时间：
1991
期刊：
影响因子：
6.2
通讯作者：
Starzl,TE
中科院分区：
文献类型：
--
作者：
Ricordi,C;Tzakis,A;Alejandro,R;Zeng,YJ;Demetris,AJ;Carroll,P;Mintz,DH;Starzl,TE
最近已经提出了用于人类和大型动物胰岛分离评估的定性和定量标准（1）。存活力的最终测试是移植到糖尿病受体后的功能活性。含胰岛素移植胰岛的形态学鉴定可提供重要的相关数据，并最终证实功能结果。最近，几个中心报道了人胰岛同种异体移植后胰岛素依赖性延长（2-5）。本报告描述了人类肝内同种异体胰岛移植后肝活检中胰岛组织的首次鉴定。人类胰岛是通过人类胰岛分离自动化方法（7）的改良（6）从2个多器官供体中获得的。使用细胞分离器（9，10）（COBE 2991，Lakewood，CO）在Eurocollins-Ficoll梯度（8）上纯化胰岛。1990年3月16日，258，000个平均直径为150 μ的胰岛（1）在上腹部清除和肝脏置换后通过门静脉注射移植（2）。该手术是在一名52岁的女性中进行的，用于浸润十二指肠壁的乏特壶腹腺癌，并伴有肝转移。如前所述，使用FK 506进行免疫抑制（2）。移植后17天进行剖腹探查以排除腹腔脓肿。在手术过程中，从肝脏进行了楔形活检。门脉间隙中保存良好的人胰岛（图1），周围无明显炎症反应。胰岛素和胰高血糖素的免疫组织化学染色（免疫过氧化物酶）证实了β（图2）和α（图3）细胞的存在。胰岛素染色明确显示大多数胰岛细胞中存在β颗粒。α细胞对胰高血糖素的染色更强烈。染色强度差异的一个可能原因可能是患者接受了全胃肠外营养。高营养可能诱导了相对的β细胞脱粒。另一个解释可能是，她接受了一个边缘数量的胰岛，可以最大限度地刺激。为了支持这一点，她是9名患者中唯一一名在移植后4个月仍需要每天注射胰岛素的患者（2）。尽管如此，胰岛功能最终得到改善，导致人类胰岛移植后6个月的胰岛素依赖性。
Qualitative and quantitative standards have been recently proposed for islet isolation assessment in humans and large animals (1). The ultimate test of viability is functional activity after transplantation into a diabetic recipient. Morphologic identification of insulincontaining transplanted islets could provide important correlative data and eventually confirm the functional results. Recently, several centers reported prolonged insulin independence after human islet allotransplantation (2–5). The present report describes the first identification of islet tissue in a liver biopsy after intrahepatic islet allotransplantation in man. Human islets were obtained from 2 multiorgan donors by a modification (6) of the automated method for human islet isolation (7). The islets were purified on Eurocollins-Ficoll gradients (8) using a cell separator (9, 10)(COBE 2991, Lakewood, CO). On March 16, 1990 258,000 islets of an average diameter of 150 μ (1) were transplanted via portal vein injection following an upper abdominal exenteration and liver replacement (2). The procedure was performed in a 52-year-old woman for adenocarcinoma of the ampulla of Vater infiltrating the duodenal wall, with liver metastasis. Immunosuppression was with FK506 as described previously (2).An exploratory laparotomy was performed 17 days after transplantation to rule out intraabdominal abscess. During the procedure a wedge biopsy was taken from the liver. A well-preserved human islet in a portal space (Fig. 1), with no significant surrounding inflammatory reaction was demonstrated. Immunohistochemical stains (immunoperoxidase) for insulin and glucagon confirmed the presence of beta (Fig. 2) and alpha (Fig. 3) cells. The insulin stain unequivocally demonstrated beta granulation in the majority of the islet cells. The alpha cells appeared more intensely stained for glucagon. A possible reason for the difference in stain intensity could be that total parenteral nutrition was administered to the patient. The hyperalimentation may have induced relative beta cell degranulation. An additional explanation may be that she received a marginal number of islets that could have been maximally stimulated. In support of this, she was the only one out of 9 patients who was still requiring daily insulin injections 4 months after transplantation (2). Nevertheless, islet function eventually improved, resulting in insulin independence 6 months after human islet transplantation.
难以捉摸的猪胰岛的分离。
影响因子：
3.8
作者：
C. Ricordi;C. Socci;A. Davalli;C. Staudacher;P. Baro;A. Vertova;I. Sassi;F. Gavazzi;G. Pozza;V. Carlo
通讯作者：
V. Carlo