Transplantation of Endocrine Cells and Tissues

Hormone replacement therapy for endocrine deficiency may not completely achieve the physiologic independence of a normally functioning system, because the complex metbolic interactions of hormones and their targets often cannot be wholly reproduced. Investigators have explored transplantation of endocrine tissues and cells with varying degrees of clinical success. Although autotransplantation (the movement of tissue or cells from one location to another in the same individual) as evidenced by the success of parathyroid autotransplantation has found clinical applicability, allotransplantation (transplantation of tissue or cells from one individual to another in the same species) has been limited by rejection. Xenotransplantation (transplantation with another species' tissue) has remained investigational. Table 77-1 shows a number of endocrine deficiency states that might be amenable to transplantation of endocrine cells or tissues. However, advances have been made in the field of pancreatic islet cell transplantation that, in addition to thyroid transplantation, parathyroid transplantation, and adrenal transplantation, are discussed in this chapter.

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