Curing Diabetes with Islet Cell Transplantation: Transitioning from Allo to Xenotransplantation

◎Wayne John Hawthorne¹
Department of Surgery, University of Sydney¹

Pancreas and Islet cell transplantation are the gold standard to treat type 1 diabetes, but
they are plagued by multiple factors including donor selection, organ procurement and
isolation parameters. This study aimed to identify the key contributing factors that
affected the outcome of islet preparations in order to proceed to transplantation.
Islets were isolated from DBD donor pancreata using collagenase and neutral protease.
Donor characteristics, procurement data, isolation yield and outcomes were analysed to
determine variables associated with transplantable yields. Data was further divided into
Transplanted (Tx) and Non-transplanted (NTx) to identify factors significantly related to
successful outcomes. Data collected from Westmead’s 320 islet isolations undertaken
between July 2000 and December 2022 will be presented. Our focus has been to improve
our overall outcomes and minimize our costs. A focus on increased donor BMI/weight
and lower CIT have contributed significantly to successful islet isolation outcomes,
resulting in significant improvements to transplantable yields of islets for treatment of our
patients suffering hypoglycemic unaware Type 1 diabetes.
However, to increase transplantation rates, we have been developing the cure to replace
or be an additional therapy to allotransplantation. We have developed xenotransplantation
to be safely introduced for clinical use. In this lecture I will present the close interaction
between the international guiding bodies, the International Xenotransplantation
Association (IXA), The Transplantation Society (TTS) and the World Health
Organization (WHO) to establish clinical xenotransplantation. Long-term monitoring of
xenotransplantation trials and outcomes have been established and a registry established
and updated regularly, in line with prior WHO guidance and current IXA
recommendations. Continuous updates to world guidelines and regulatory guidance
documents are indicated, in line with the ongoing technological advancements and
findings from current studies, to ensure the most up-to-date implementation of guidance
at the global level. This is clearly crucial, as evident from the outcomes of the Changsha
Global Consultation Continued involvement of representatives from all disciplines are
essential to discuss progress and innovations in the field, to mirror this progress with
respect to regulatory oversight, and foster this at the global level under the umbrella of
the three international guiding organizations of the IXA, TTS and WHO. This lecture will
provide an update on how these processes have occurred and provide data on ongoing
updates for potential clinical trials.

略歴
Positions and Honors.
1998-09 Senior Lecturer/Senior Research Fellow, Dept of Surgery, University of Sydney.
2006- Director of National Pancreas & Islet Transplant Laboratories, Westmead Hospital, Westmead.
2010-17 Associate Professor, Dept of Surgery, University of Sydney at Westmead Hospital.
2017- Professor of Transplantation, Dept of Surgery, University of Sydney.
2019- President Australasian College of Biomedical Scientists.
2020- President International Xenotransplantation Association (IXA).
Honors
1991 Surgical Research Society Young Investigator of the Year Award.
1995 Centenary Fellowship for Medicine, University of Sydney.
1996 Jansen Cilag International Travel Fellowship, Transplantation Society Australia and New Zealand (TSANZ).
2003 Inaugural Winner of the prestigious “McKenzie Fellowship for Transplantation” from TSANZ.
2007 Key Opinion Leader award. The International Transplant Society (TTS).
2010 Winner XENOME AWARD (European Union), Xenome is an integrated project in the European Sixth Framework Program
presented at the 16th Nantes/Actualités/Transplantation.
2014 Kidney Health Australia - TSANZ National Meeting “Best Research in the Field of Laboratory Research”.
2015 Australia–Harvard Fellowship - Beth Israel Deaconess, Harvard Medical School, Auto Islet Cell Transplant.2018 Visiting Professor appointment, The Second Hospital of Central South University, Changsha, CHINA.
2018 Kidney Health Australia - TSANZ National Meeting “Best Research in the Field of Clinical Research”
2022 Best Presentation - TSANZ National Meeting “Best Research in the Field of Laboratory Research”