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Diabetes 57:2269-2271, 2008
DOI: 10.2337/db08-0814
© 2008 by the American Diabetes Association
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Commentary

Revascularization of Transplanted Islets

Can It Be Improved?

Marcela Brissova1, and Alvin C. Powers1,2,3

1 Department of Medicine, Division of Diabetes, Endocrinology, and Metabolism, Vanderbilt University, Nashville, Tennessee
2 Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee
3 VA Tennessee Valley Healthcare System, Nashville, Tennessee

Corresponding author: Alvin C. Powers, al.powers@vanderbilt.edu

The first 20% of the full text of this article appears below.

Pancreatic islets are highly vascularized, which is important in their ability to quickly secrete insulin in response to changes in blood glucose. Although pancreatic islets comprise only 1–2% of pancreatic mass, they receive 5–10% of pancreatic blood flow. Blood vessels within pancreatic islets are of a greater density than those in surrounding exocrine tissue and are lined with fenestrated endothelial cells. These specialized features are responsible for the greater partial pressure of oxygen in islets compared with acinar tissue and other organs, which is likely important for normal islet cell function. Islet production of angiogenic factors such as vascular endothelial growth factor-A (VEGF-A) and angiopoietin-1 is critical for creating this highly vascularized state (1,2). During embryonic development, reciprocal endothelial-endocrine cell signaling and the formation of functional blood vessels appear to instruct pancreatic differentiation and morphogenesis (3–5). Development of the islet vasculature is coordinated with islet formation, but blood flow to endocrine cells precedes their final assembly into a mature islet (2).

Pancreatic islet isolation severs the connections between the islet vasculature and the systemic circulation. In contrast with whole-organ transplantation, where organ perfusion is quickly reestablished by reconnection of arterial and venous vessels, the reestablishment of blood flow to transplanted islets requires several days and involves angiogenesis and possibly vasculogenesis. Not only are islets avascular for several days following transplantation, they are less vascularized and have a lower oxygen tension than islets in the pancreas when revascularization is complete . . . [Full Text of this Article]


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Diabetes 2008 57: 2393-2401. [Abstract] [Full Text] [PDF]





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Copyright © 2008 by the American Diabetes Association.