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The e-mémoires of the Académie Nationale de Chirurgie

Feasibility and safety of endoscopic transplantation of cells into the digestive submucosa for islet transplantation: a preclinical study in minipigs

Sarah BENHALIMA

Seance of wednesday 22 may 2024 (Séance commune à l'amphithéâtre Saint-Côme avec l'Académie Nationale de Médecine : La recherche en chirurgie)

DOI number : 10.26299/k2z4-qh10/emem.2024.17.04

Abstract

Introduction :
Islet transplantation (IT) has been validated for the treatment of unbalanced type 1 diabetes. Performed in the portal vein, its low yield require to look for alternative sites. IT in the gastric submucosa has shown promising results.

Objective :
The aim of this study is to develop cells transplantation in the digestive submucosa by carrying out a feasibility and safety study of endoscopic transplantation in minipigs.

Material & Method :
"Cellular models" of microbeads and adipocytes, were used, first on ex vivo organs (duodenum, stomach, rectum) and then in minipigs, to assess the biomechanical characteristics of the submucosal graft, the operative complications and the graft integration properties on an histological study.

Results :
The optimal volume is 1 mL, regardless of concentration. There was no morbidity or mortality associated with the technique. The histological study confirmed the absence of necrosis. A functional study is required to validate these results for islet transplantation.