Survival of macroencapsulated allogeneic parathyroid tissue one year aftertransplantation in nonimmunosuppressed humans

The use of immunoisolation devices may allow transplantation without need f or immunosuppression and could widen the indications for cell transplantati on. In this study, we evaluated the survival of encapsulated parathyroid ti ssue in nonimmunosuppressed humans. Autologous parathyroid implants: Seven patients undergoing parathyroidectomy had devices containing small pieces o f their own parathyroid tissue implanted SC. These devices were explanted a fter 2-4 weeks for histological evaluation. Allogenic parathyroid implants: Four patients with chronic hypoparathyroidism. were transplanted with one to three large (40 mul) and one small (4.5 mul) device filled with meshed p arathyroid tissue and implanted SC. The small devices were explanted at 4 w eeks, while the large ones were explanted 8.5 to 14 months after implantati on. In both studies, control implants were placed in nude mice. Autologous study results: At explantation, the grafts consisted of 22 +/- 6% endocrine tissue and 63 +/- 7% fibrosis, while 15 +/- 5% of the grafts were necrotic . Allogenic study results: In devices explanted from the patients at 4 week s, fibrosis dominated and only 1%, 5%, and 23% of the grafts consisted of e ndocrine tissue. A similar histological appearance was found in grafts from nude mice. In devices explanted at 8.5-14 months, histologically intact en docrine tissue was found in all patients. However, nearly all the tissue co nsisted of fibrosis. There was no detectable increase in the parathormone ( PTH) level in all patients. Macroencapsulated human allogeneic parathyroid tissue can survive up to I year after transplantation into nonimmunosuppres sed patients. However, marked fibroblast overgrowth occurred, especially in the allogeneic implant study, using meshed parathyroid tissue. This was pr obably not related to the allo-response, because similar findings were obse rved in the nude mouse implants. In future studies, better tissue preparati on and improvements in the physiological milieu inside the device may help to reduce fibroblast overgrowth and increase survival of the parathyroid ce lls.