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Endocrine Abstracts (2022) 88 002 | DOI: 10.1530/endoabs.88.002

BES2022 BES 2022 Abstracts (23 abstracts)

Function and composition of pancreatic islet cell implants in omentum of type 1 diabetes patients

Van Hulle F 1 , De Groot K 1 , Hilbrands R 1,2 , Van de Velde U 1,2 , Suenens K 1 , Stangé G 1 , De Mesmaeker I 1,3 , De Paep DL 1,3,4 , Ling Z 1,3 , Roep B 5 , Gillard P 6 , Pipeleers D 1 , Keymeulen B 1,2 & Jacobs- Tulleneers-Thevissen D 1,4


1Diabetes Research Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium; 2Diabetes Clinic, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium; 3Beta Cell Bank, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium; 4Department of Surgery, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium; 5Department Internal Medicine, Leiden University Medical Center – LUMC, Leiden, The Netherlands; 6Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium


Introduction: Intraportal (IP) islet cell transplants can restore metabolic control in type 1 diabetes patients, but limitations raise the need for establishing a functional beta cell mass (FBM) in a confined extrahepatic site.

Methods: This study reports on function and composition of omental (OM) implants after placement of islet cell grafts with similar beta cell mass as in our IP-protocol (2–5.106 beta cells/kg body weight)

Results: Four of seven C-peptide-negative recipients achieved low beta cell function (hyperglycemic clamp [HGC] 2–8 percent of controls) until laparoscopy, 2–6 months later, for OM-biopsy and concomitant IP-transplant with similar beta cell dose. This IP-transplant increased HGC-values to 15–40 percent. OM-biopsies reflected the composition of initial grafts, exhibiting varying proportions of endocrine- cell-enriched clusters with more beta than alpha cells and leucocyte pole, non-endocrine cytokeratin- positive clusters surrounded by leucocytes, and scaffold remnants with foreign body reaction. OM- implants on a polyglactin-thrombin-fibrinogen-scaffold presented larger endocrine clusters with infiltrating endothelial cells and corresponded to the higher HGC-values. No activation of cellular immunity to GAD/IA2 was measured post-OM-transplant.

Conclusion: Establishment of a metabolically adequate FBM in omentum may require a higher beta cell number in grafts but also elimination of their immunogenic non-endocrine components as well as local conditioning that favors endocrine cell engraftment and function.

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