CC BY-NC 4.0 · Arch Plast Surg 2021; 48(01): 133-143
DOI: 10.5999/aps.2020.01865
Research/Experimental
Original Article

Suitability of denervated muscle flaps as recipient sites for pancreatic islet cell transplantation

Banobagi Plastic Surgery, Seoul, Korea
,
Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
,
Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
› Author Affiliations

Background Extensive research has been conducted on islet transplantation as a possible cure for diabetes. Islet transplantation in the liver via the portal vein has shown remarkable results, but numerous other recipient sites are currently being investigated. We aimed to show the effectiveness of using a muscle flap as a recipient site for islet transplantation.

Methods Islet cells were harvested from 12 isogenic Lewis rats, and then diabetes was induced in another 12 isogenic Lewis rats by streptozotocin injection. In six rats, 3,000 islets were transplanted into gastrocnemius muscle flaps, and in the other six rats, the same number of islets were transplanted into the gastrocnemius muscle. The transplanted islet cell function between the two groups was compared by means of blood glucose tests, glucose tolerance tests, immunohistochemistry, and real-time reverse transcription polymerase chain reaction.

Results In the muscle flap group, blood glucose levels significantly decreased after islet transplantation. Blood glucose levels were significantly different between the two groups at 3 weeks after transplantation. The muscle flap group showed nearly normoglycemic results upon the glucose tolerance test, whereas the muscle group was hyperglycemic. Immunohistochemical evaluation showed positive results against insulin and glucagon in biopsies of both groups, and the islet cell density was higher in the muscle flap group. There were no statistically significant differences between the two groups in real-time reverse transcription polymerase chain reaction results.

Conclusions Our results suggest that muscle flaps are promising candidates for islet cell transplantation.



Publication History

Received: 22 September 2020

Accepted: 18 November 2020

Article published online:
20 March 2022

© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Bennet W, Groth CG, Larsson R. et al. Isolated human islets trigger an instant blood mediated inflammatory reaction: implications for intraportal islet transplantation as a treatment for patients with type 1 diabetes. Ups J Med Sci 2000; 105: 125-33
  • 2 Carlsson PO, Palm F, Andersson A. et al. Markedly decreased oxygen tension in transplanted rat pancreatic islets irrespective of the implantation site. Diabetes 2001; 50: 489-95
  • 3 Korsgren O, Nilsson B, Berne C. et al. Current status of clinical islet transplantation. Transplantation 2005; 79: 1289-93
  • 4 Carlsson PO, Nordin A, Palm F. pH is decreased in transplanted rat pancreatic islets. Am J Physiol Endocrinol Metab 2003; 284: E499-504
  • 5 Guy AJ, Griffin SM, Alderson D. et al. Metabolic comparison between canine islet autografts with portal and peripheral venous drainage. Transplant Proc 1987; 19: 3918-20
  • 6 Christoffersson G, Henriksnas J, Johansson L. et al. Clinical and experimental pancreatic islet transplantation to striated muscle: establishment of a vascular system similar to that in native islets. Diabetes 2010; 59: 2569-78
  • 7 Sterkers A, Hubert T, Gmyr V. et al. Islet survival and function following intramuscular autotransplantation in the minipig. Am J Transplant 2013; 13: 891-8
  • 8 Kim HI, Yu JE, Park CG. et al. Comparison of four pancreatic islet implantation sites. J Korean Med Sci 2010; 25: 203-10
  • 9 Espes D, Eriksson O, Lau J. et al. Striated muscle as implantation site for transplanted pancreatic islets. J Transplant 2011; 2011: 352043
  • 10 Borud LJ, Shaw WW, Passaro Jr E. et al. The fasciovascular flap: a new vehicle for islet transplantation. Cell Transplant 1994; 3: 509-14
  • 11 Kaufman DB, Morel P, Field MJ. et al. Purified canine islet autografts: functional outcome as influenced by islet number and implantation site. Transplantation 1990; 50: 385-91
  • 12 Yasunami Y, Lacy PE, Finke EH. A new site for islet transplantation: a peritoneal-omental pouch. Transplantation 1983; 36: 181-2
  • 13 Troitzsch D, Vogt S, Abdul-Khaliq H. et al. Muscle tissue oxygen tension and oxidative metabolism during ischemia and reperfusion. J Surg Res 2005; 128: 9-14
  • 14 Rafael E, Tibell A, Ryden M. et al. Intramuscular autotransplantation of pancreatic islets in a 7-year-old child: a 2-year follow-up. Am J Transplant 2008; 8: 458-62
  • 15 Stegall MD. Monitoring human islet allografts using a forearm biopsy site. Ann Transplant 1997; 2: 8-11
  • 16 Moberg L, Olsson A, Berne C. et al. Nicotinamide inhibits tissue factor expression in isolated human pancreatic islets: implications for clinical islet transplantation. Transplantation 2003; 76: 1285-8
  • 17 Cabric S, Sanchez J, Lundgren T. et al. Islet surface heparinization prevents the instant blood-mediated inflammatory reaction in islet transplantation. Diabetes 2007; 56: 2008-15
  • 18 Goto M, Johansson H, Maeda A. et al. Low molecular weight dextran sulfate prevents the instant blood-mediated inflammatory reaction induced by adult porcine islets. Transplantation 2004; 77: 741-7
  • 19 Bennet W, Sundberg B, Groth CG. et al. Incompatibility between human blood and isolated islets of Langerhans: a finding with implications for clinical intraportal islet transplantation?. Diabetes 1999; 48: 1907-14
  • 20 Tominaga Y, Uchida K, Haba T. et al. More than 1,000 cases of total parathyroidectomy with forearm autograft for renal hyperparathyroidism. Am J Kidney Dis 2001; 38: S168-71
  • 21 De Vos P, De Haan BJ, Vegter D. et al. Insulin levels after portal and systemic insulin infusion differ in a dose-dependent fashion. Horm Metab Res 1998; 30: 721-5
  • 22 Borud LJ, Shaw WW, Brunicardi FC. et al. Prefabrication of a neo-endocrine organ: a rat model. J Surg Res 1996; 61: 221-6
  • 23 Black KS, Hewitt CW, Grisham GR. et al. Two new composite tissue allograft models in rats to study neuromuscular functional return. Transplant Proc 1987; 19: 1118-9
  • 24 Tonken HP, Zhang F, Sudekum AE. et al. Microvascular transplant of the gastrocnemius muscle in rats. Microsurgery 1993; 14: 120-4