From Iron Mountain, Michigan, USA:
I often hear, in the discussion of islet cell transplantation, that the availability of human islet cells (or lack thereof) would be a major stumbling block in having this procedure available to all who need it, being that islet cells can not replicate, regenerate, or multiply. With the recent news of being able to "manufacture" organs through cloning, wouldn't this be a simple solution to this islet availability problem? If you can recreate a whole organ, wouldn't you be able to "manufacture" a cell?
There has been some very recent work that shows that islet cells can indeed be induced to regenerate; but our understanding of this process still falls a long way short of any clinical applicability. In the meantime, human islet cell transplantation remains a disappointment with success rate around 25% at two years. And of course there is a supply problem since islet cells cannot be cultured.
However, there are grounds for optimism over the future. A group in Germany have significantly improved the success rate to around 45% with modifications of both the islet cell extraction procedure and the post transplant immunosuppression. There is also some work in the very earliest stage with encapsulated neonatal pork islets where the recipient is on nicotinamide and a casein free diet that looks as though it might really offer something new. My guess, then, is that some form of xenotransplantation will ultimately be the way to go, not allotransplantation.
Original posting 2 Aug 97
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