Applications of organ precursor cell therapy: can lessons from embryonic kidney transplantation be applied to the endocrine pancreas?

PURPOSE OF REVIEW: The purpose of this review is to provide an update relating to a novel approach to endocrine pancreas replacement therapy based in part on a technology developed for the transplantation of developing kidneys. The approach is to use organ primordia, and in this way transplant kidneys or pancreas in cellular form.

RECENT FINDINGS: Cellular allotransplantation and xenotransplantation of both kidney and pancreatic anlagen has been successfully performed such that functioning organs develop in situ.

SUMMARY: The number of human organs available for transplantation is limited. We and others have shown that it is possible to 'grow' new kidneys or endocrine pancreas from organ-specific precursor cells in situ. For the kidney, this technology takes advantage of the fact that a developing renal anlagen can attract its blood supply from an appropriate vascular bed post-transplantation, enabling the transplantation of kidneys in 'cellular' form. Techniques developed for the transplantation of embryonic kidneys can be applied to the transplantation of embryonic pancreas. Pancreatic anlagen implanted into a host peritoneum develop into a novel organ consisting of functional islets of Langerhans surrounded by stroma. The transplantation of developing pancreas could represent a novel 'cellular' treatment for diabetes mellitus, a major cause of end-stage renal disease.