Allogeneic transplantation of islets of Langerhans was facilitated by the cotransplantation of syngeneic myoblasts genetically engineered to express the Fas ligand (FasL). Composite grafting of allogeneic islets with syngeneic myoblasts expressing FasL protected the islet graft from immune rejection and maintained normoglycemia for more than 80 days in mice with streptozotocin-induced diabetes. Graft survival was not prolonged with composite grafts of unmodified myoblasts or Fas-expressing myoblasts. Islet allografts transplanted separately from FasL-expressing myoblasts into the contralateral kidney were rejected, as were similarly transplanted third-party thyroid allografts. Thus, the FasL signal provided site- and immune-specific protection of islet allografts.

Objective: Gastroschisis is a rare congenital abdominal wall defect through which intraabdominal organs herniate and it requires surgical management soon after birth. The objectives of this study were to profile patient characteristics of this anomaly utilizing data from two large national databases and to validate previous risk stratification categories of infants born with this condition.Methods: An analysis was performed using 13 years of the National Inpatient Sample database (1988-1996, 1998, 1999, 2001, 2002) and 3 years of the Kids' Inpatient Database (1997, 2000. These combined databases contain information from nearly 93 million discharges in the United States. Infants with gastroschisis were identified by International Classification of Disease-9 procedure code 54.71 (repair of gastroschisis) and an age at admission of <8 days. Variables of gender, race, geographic region, co-existing diagnoses, length of stay, hospital charges adjusted to 2005 dollars, complications and inpatient mortality were collected from the databases. Infants were divided into simple and complex categories based on the absence or presence of intestinal atresia, stenosis, perforation, necrosis or volvulus. Comparisons between groups were performed using Pearson's w 2 for categorical outcomes and the Kruskal-Wallis test for non-normally distributed continuous variables.Results: A total of 4344 infants with gastroschisis were identified. These were comprised of 44.0% female infants (n ¼ 1910), 46.4% male infants (n ¼ 2017) whereas 9.6% were not reported (n ¼ 415). Racial analysis showed the largest subset being white in 40.9% of infants (n ¼ 1775) with Hispanic infants being the next highest group reported at 17.2% (n ¼ 745). Co-existing intestinal anomalies were the most common, affecting 9.9% (n ¼ 429) infants, whereas certain cardiac (6.8%, n ¼ 294) and pulmonary (1.7%, n ¼ 72) conditions were also identified. Simple gastroschisis represented 89.1% (n ¼ 3870) of the group whereas 10.9% (n ¼ 474) were complex in nature. Simple and complex patients differed in median length of stay (28 vs 67 days, P<0.01), inpatient mortality (2.9 vs 8.7%, P<0.01) and median inflation-adjusted hospital charges ($90 788 vs $197 871, P<0.01).Conclusions: These data represent a national analysis of the largest group of infants with gastroschisis to date which further aids the characterization and understanding of this serious congenital condition.