Mixed xenogeneic chimerism (mouse+rat-->mouse) to induce donor-specific tolerance to sequential or simultaneous islet xenografts.

We previously reported that donor-specific rat islet xenografts were accepted by fully xenogeneic (rat-->mouse) chimeras when the islets were transplanted at least six weeks following reconstitution. The purpose of the present study was to examine whether a similar outcome would occur for mixed xenogeneic (mouse+rat-->mouse) chimeras if the islets were placed coincident with the time of bone marrow infusion. As with fully xenogeneic chimeras (rat-->mouse), synchronous donor-specific F344 rat (Rt1A1) islet xenografts were significantly prolonged (MST > 139 days) in mixed xenogeneic (mouse+rat-->mouse) chimeras, while MHC-disparate third-party WF rat (Rt1Au) grafts were rejected (MST = 21.2 days). The transplanted donor-specific islets were functional to maintain euglycemia and they were regulated in function to respond to a glucose challenge. For potential clinical application, it would be of obvious benefit if the islet xenografts could be placed at the time of bone marrow transplantation. We therefore performed similar studies using donor islets administered simultaneously with bone marrow. Donor-specific islet xenografts were permanently accepted by all mouse recipients (n = 5). When MHC-disparate third-party rat islets were transplanted, only 3 of 8 islet xenografts were rejected; the other 5 remained functional from 77 to 90 days posttransplantation. Although prolonged and functional, the MHC-disparate islets that were accepted exhibited histologic evidence of fibrosis and rejection, while those matched to the donor did not. These data therefore suggest that donor-specific islet xenografts are permanently accepted if placed simultaneously or sequentially following mixed xenogeneic bone marrow reconstitution.