Avoiding Immunosuppression for Islet Transplantation: Use of Protective Biomaterials

Michael Alexander, Huy Nguyen, Antonio Flores, Shiri Li, Paulus de Vos, E Botvinick, Jonathan R T Lakey

Research output: Book/ReportBookAcademic


Islet transplantation, with the advent of the Edmonton protocol in 2000, has offered a significant
alternative for long-lasting treatment of type 1 diabetes. However, the immunosuppression
required for transplantation has the cytotoxic effect on pancreatic islets, and
thus limiting the long-term efficacy of the transplant. Immediate loss of islets after transplant
was also observed because of immediate blood-mediated inflammatory response
(IBMIR), which kills islets transplanted in the liver through portal vein. There is also
commonly a lack of microvascular blood supply to the transplanted islets. In this chapter,
we will review the variety of technologies used to protect transplanted islets against
toxicity of immunosuppression, immune rejection, and inflammatory response. We will
evaluate the mechanisms of these technologies and their progress in solving the challenges
to islet transplantation. The technologies include encapsulation of transplanted
islets in various polymers, transplants in sites other than the liver, and creation of new
prevascularized transplant site. These technologies offer several mechanisms to prevent
immune rejection or immediate contact with cytotoxic inflammatory response, in addition
to maintaining islet integrity. New transplant sites are also being developed to support
the islets, by allowing establishment of microvasculature and innervation, prior to
addition of the islets.
Original languageEnglish
Number of pages14
ISBN (Print)978-953-51-4930-9
Publication statusPublished - 26-Apr-2017

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