Researchers at the Institute for Cellular Transplantation, under the leadership of Horacio Rilo, MD, are finding ways to transplant your own cells into your body to treat and regenerate diseased tissues and physiological processes. The Institute's work falls into three areas: clinical patient care, translational research, and community advocacy.

Islet Transplantation

Auto-islet transplantation is an example of such a procedure involving the pancreas and insulin production. When the pancreas is chronically diseased, it can no longer produce insulin. As a result, a patient with chronic pancreatitis may develop "brittle diabetes," a complex and more extreme form of diabetes.

During the auto-islet transplantation, surgeons remove the patient's diseased pancreas, extract the cells that produce insulin (called "islet cells") and then transfer those cells into the patient's liver. The liver then "learns" to produce insulin, curing the patient of brittle diabetes.

UA surgeons are the first in the Southwest to perform successful auto-islet cell transplants in patients with severe chronic pancreatitis. Dr. Rilo is a world leader in this process, having established transplant centers in Pittsburgh, Chicago, Cincinnati, Charleston, and now Tucson.

Dr. Rilo is also interested in performing allo–islet transplants (using a donated pancreas) for Type 1 diabetic patients to reverse their diabetes and is seeking FDA approval based on evidence that one of his previously Type I diabetic patients who underwent this diabetes reversal therapy in 2001 is still insulin-free.

More information on islet cell tranplants for the treatment of chronic pancreatitis, go to the website: Comprehensive Center for Chronic Pancreatitis.

Wound healing and artificial skin

Diabetes increases the severity of wounds, sometimes making them chronic wounds that don’t heal without intervention. Researchers collaborate with plastic surgeons on new ways to heal wounds more efficiently with skin grafts. They have developed an innovative “glue-like” suspension of microscopic bits of the patient’s own skin that can fill the wound. These microscopic skin particles then grow together and heal the wound. With this method, doctors don’t need to rely on artificial skin grafts and don’t need as much of the patient’s own skin to cover a wound, thus reducing invasiveness and healing time.

Researches have also engineered a novel device that can sew together biologically compatible threads into a matting of controlled size and thickness, which is then placed over a wound to promote healing. This success of this research would obviate the need to use the patients’ own skin harvested from another part of the body.

Nipple areola cryopreservation project

When women undergo radical mastectomies today, the nipple tissue is not harvested, even when it is cancer-free. Thus, when later undergoing reconstruction, the shape of the nipple can be roughly re-created, but not the function or true color. Dr. Rilo’s lab is working with plastic surgeons and cancer physicians to find ways of cryopreserving cancer-free nipple tissue so that it can be re-attached during reconstructive surgery, thus salvaging both the form and function of the tissue.

Bioengineered tissue and stem cell therapy

Harvesting adult stem cells from fat and bone marrow, storing them, and then using them later to regenerate other tissue is part of the Institute for Cellular Transplantation’s research. Adult stem cells offer advantages over other stem cell strategies because they are the patient’s own cells that are transplanted back, and the new tissues don’t react with the body’s immune system. Avoiding this response increases the success rate of the transplant. Active projects include using stem cells to treat Parkinson’s disease, degenerative knee injuries, chronic-wound healing, and diabetes reversal therapy.

Kidney preservation for transplantation

When kidneys are harvested from donors, the choice of fluid in which they are packaged and transported can affect the outcome for the organ recipient. Dr. Rilo’s lab has determined which fluid offers the best nutrients and environment for the organs, and they are working on ways to educate surgeons about what they should request before kidney transport.  They also are determining if this fluid works well enough for kidneys that would normally be excluded from the donor pool due to age or time of death, to be transplanted.

Kidney markers in urine that indicate kidney failure

Fifty people who have either undergone a kidney transplant or soon will are enrolled in this study to determine if there are biomarkers in urine that indicate when a transplanted kidney is succeeding or failing. There are more than 30,000 kidney transplants performed each year-- not enough to keep up with demand. The cost of the surgery and lifelong treatment is very high and the success rate of the transplant is not 100 percent. This research seeks to identify and mitigate a failing transplanted kidney before another surgery and/ or dialysis is required.

Cellular encapsulation

Finding ways to perfect the coating around islet cells is a priority, so that when they are transplanted during a therapeutic procedure, the islet cells are not attacked by other immune cells that “think” they are invaders. One potential strategy for diabetes reversal therapy is to transplant into a diabetic patient, donated islets that have been isolated in Dr. Rilo’s facility. The patient’s immune system would normally attack the islets if the patient is not on immunosuppressive therapy, but if the coating around the islets can be modified or replaced and mask the transplanted cells, then immunosuppressive therapy might not be required as a long-term strategy.

Zebra fish model

Dr. Rilo is the only researcher at the UA who uses this animal model for his genetic and developmental studies. The zebra fish is uniquely suited because its DNA encodes the same genes as human DNA with remarkable conservation albeit half the number. These animals are large and transparent when they are developing, enabling Dr. Rilo’s team to watch blood vessels and organs develop as the fish grows. The fish are readily engineered to glow when and where genes are turned on or off and they offer an excellent high-throughput method for drug discovery and toxicity studies.

COMMUNITY ADVOCACY

Diabetes Management and Prevention Project

Diabetes is called the silent killer, because the disease can be quite progressed before a patient has symptoms. The Institute's Diabetes Center goals include creating a multi-pronged approach to the prevention and management of the disease so that complications can be avoided. His most recent project, which was undertaken in partnership with several community groups, was to determine if patient education alone had a positive impact on blood sugar management. It did. Significantly.

The project involved using continuous glucose monitors, bioelectrical impedance analysis, activity monitors and grass roots outreach to underserved and out-of-reach populations in the local community. Armed with cutting edge, portable technology to track a person’s body functions can arm them with the facts, and researchers found that, for many patients, that was enough to modify their behavior and reduce the possibility of complications.

For more information on the Institute for Cellular Transplantation, call (520) 626-4341.