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Toward clinical trials of islet xenotransplantation

In a recent Commentary in Xenotransplantation, Philip O’Connell outlines the challenges of pigto-human islet transplantation (Tx). His emphasis is on the prevention of the xenogeneic immune reaction [1]. In the present Commentary, we attempt to provide a road map toward clinical pig islet Tx. The success with human islet Tx achieved in Edmonton [2] has stimulated worldwide interest in the Tx of the islets of Langerhans. In view of the scarcity of human tissue, it will not, however, be possible to apply islet Tx on a large scale unless a surrogate insulin-producing tissue is made available. Pig insulin was used for several decades to treat diabetic patients, and the structure of pig insulin is very similar to that of human insulin; thus porcine islets would offer an alternative.