Trying to Prevent the Clogged Drain: Optimizing the Yield and Function of Portal Vein-Infused Islets

Vasculogenic hydrogel enhances islet survival, engraftment, and function in leading extrahepatic sites

“…Clinical trials with intrahepatic allogeneic islet transplantation have demonstrated insulin independence in diabetic patients, but the median duration of insulin independence is only 35 months and requires multiple donor pancreata (4). Although clinically accessible for islet delivery, the hepatic vasculature is an inhospitable transplant site, as evidenced by suboptimal performance of grafts in islet autotransplantation after total pancreatectomy (5,6). Instant blood-mediated inflammatory responses to intraportally infused islets contribute to rapid graft destruction (7)(8)(9), resulting in an immediate loss of 50 to 60% of the graft (10), a substantial barrier to the translation of this therapy.…”

Enhancement of Subcutaneously Transplanted β Cell Survival Using 3D Stem Cell Spheroids with Proangiogenic and Prosurvival Potential

“…The loss of insulin dependency is attributable to a significant loss of infused cells, as the portal vasculature may not be an optimal site of engraftment 7. Both the blood‐mediated inflammatory reaction and the subsequent immune responses reportedly contribute to severe graft destruction, limiting the survival and functioning of insulin‐secreting cells.…”