Human fetal pancreas (HFP) has the unique capacity for further growth and differentiation following transplantation to a diabetic recipient. The objective of our funded application was to determine the parameters required for the procurement, processing, storage, HLA typing, and testing for bacterial and viral contamination of HFP. We have achieved these goals and have established protocols for obtaining high quality tissue with good function. Our studies have advanced the field of HFP transplantation to the point where clinical trials can be, initiated. Three problems remain which limit the potential of HFP for successful clinical transplantation: 1) HFP requires up to three months following transplantation before acquisition of glucose responsiveness during which time it is not possible to monitor graft rejection, 2) HFP has a small mass of tissue and may require 20 or more pancreata for successful transplantation, and 3) HFP transplantation is subject to both allograft and autoimmune responses. Our long-term goal is to achieve successful HFP transplantation. Thus the objectives of this application are to: 1) Characterize both the allograft and autoimmune response to HFP and cellular subsets of HFP tissue. We will use mixed lymphocyte islet cell culture and specific lymphoid depletion to determine 1) the contribution of cellular and cytokine responses and 2) the role of direct and indirect antigen presentation to HFP graft loss. We will use this knowledge to design clinically relevant strategies for immunosuppressive therapy, 2) Accelerate the differentiation of HFP glucose responsiveness. We will use short-term culture and adenoviral-mediated gene transfer of specific growth and transcription factors to accelerate HFP differentiation and maturation, and 3) Demonstrate the potential to increase HFP beta cell mass in vitro with transient transformation of HFP with SV40-T antigen while maintaining beta cell function. We will use beta cell enriched HFP subpopulations infected with replication- defective adenovirus expressing SV40-T antigen to demonstrate the potential to increase beta cell mass without loss of HFP function. The results of these studies will provide a sufficient source of HFP tissue for clinical transplantation which responds to glucose challenge and requires minimal immunosuppressive therapy.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK049545-06
Application #
2905726
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Program Officer
Harmon, Joan T
Project Start
1994-09-01
Project End
2002-08-31
Budget Start
1999-09-01
Budget End
2000-08-31
Support Year
6
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of Wisconsin Madison
Department
Surgery
Type
Schools of Medicine
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
MacKenzie, D A; Sollinger, H W; Hullett, D A (2003) Decreased immunogenicity of human fetal pancreas allografts following hyperbaric oxygen culture. Transplant Proc 35:1499-502
MacKenzie, D A; Sollinger, H W; Hullett, D A (2003) Removal of CD45+ cells from human fetal pancreas alters immunogenicity in vitro. Transplant Proc 35:1506-7
O'Herrin, Jaquelyn K; Hullett, Debra A; Heisey, Dennis M et al. (2002) A retrospective evaluation of 1,25-dihydroxyvitamin D(3) and its potential effects on renal allograft function. Am J Nephrol 22:515-20
MacKenzie, D A; Sollinger, H W; Hullett, D A (1999) Analysis of passenger cell composition of human fetal pancreas: implications for transplantation. Transplant Proc 31:651
Hullett, D A (1996) Gene therapy in transplantation. J Heart Lung Transplant 15:857-62
Hullett, D A; Geraghty, J G; Stoltenberg, R L et al. (1996) The impact of acute rejection on the development of intimal hyperplasia associated with chronic rejection. Transplantation 62:1842-6