Liver ischemia contributes to early islet failure following intraportal transplantation: benefits of liver ischemic-preconditioning

Am J Transplant. 2006 Jan;6(1):60-8. doi: 10.1111/j.1600-6143.2005.01157.x.

Abstract

Early graft failure following intraportal islet transplantation (IPIT) represents a major obstacle for successful islet transplantation. Here, we examined the role of islet emboli in the induction of early graft failure and utilized a strategy of ischemic-preconditioning (IP) to prevent early islet destruction in a model of syngeneic IPIT in STZ-induced diabetic mice. Numerous focal areas of liver necrosis associated with the islet emboli were observed within 24 h post-IPIT. Pro-inflammatory cytokines, IL-1beta and IL-6, were significantly increased 3 h after IPIT, while TNF-alpha was elevated for up to 5 days post-IPIT. Caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling positive cells were observed in the transplanted islets trapped in areas of necrotic liver at 3 h and 1 day post-IPIT. Hyperglycemia was corrected immediately following IPIT of 200 islets, but recurrence of hyperglycemia was observed within 14 days associated with a poor response to glucose challenge. IP, a procedure of pre-exposure of the liver to transient ischemia and reperfusion, protected the liver from embolism-induced ischemic injury and prevented early islet graft failure. These data suggest that islet embolism in the portal vein is a major cause of functional loss following IPIT that can be prevented by liver IP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Apoptosis
  • Caspase 3
  • Caspases / metabolism
  • Cytokines / metabolism
  • Diabetes Mellitus, Experimental / therapy*
  • Embolism / pathology
  • Graft Rejection / prevention & control*
  • Green Fluorescent Proteins / analysis
  • Green Fluorescent Proteins / genetics
  • Hyperglycemia / therapy
  • Ischemia / pathology
  • Ischemia / prevention & control
  • Ischemic Preconditioning / methods*
  • Islets of Langerhans / blood supply
  • Islets of Langerhans / pathology
  • Islets of Langerhans Transplantation*
  • Liver / blood supply*
  • Liver / pathology
  • Mice
  • Mice, Transgenic
  • Portal Vein / pathology

Substances

  • Cytokines
  • Green Fluorescent Proteins
  • Casp3 protein, mouse
  • Caspase 3
  • Caspases