Islet transplantation is an emerging therapy for type 1 diabetes (T1D) that aims to restore the body’s ability to make insulin. In this minimally invasive procedure, insulin-producing mini-organs (“islets”) are taken from a donor pancreas and delivered into the liver of a person with T1D. These islets then help stabilize blood sugar levels, reduce the chances of serious hypoglycemia or low blood sugar episodes, and in some cases may reduce, or even remove, the need for insulin injections. However, islet transplantation is only offered to people with T1D who experience dangerous blood glucose fluctuations despite using the best available treatment or management.
A major barrier is the need for lifelong immunosuppression (anti-rejection drugs) to keep the transplanted islets alive. These medications can increase the risk of infections and certain cancers, and may cause long-term side effects such as kidney and nerve damage. For most people, these risks outweigh the benefits, especially given how effective modern insulin therapy and continuous glucose monitors (CGMs) have become. Another challenge is the limited supply of donor islets. The process of removing and purifying islets from donor pancreases is difficult, and the quality of the purified cells is variable. This means that usually, more than one donor is needed for a single recipient.
Despite these challenges, islet transplantation is life-changing for some people, which is why researchers are actively working to overcome the barriers to it. For example, “invisible” islets have recently been developed, which are able to stay alive without anti-rejection drugs. Alternate sources of islets, such as stem cells or pigs, are also being explored extensively to overcome the donor shortage. While more research is needed, these advances offer real hope for islet transplantation becoming available to more people with T1D for healthier, burden-free lives.
About the author
Arghyadip Bose
Arghyadip is a PhD student in the Department of Surgery at the University of Alberta, studying islet transplantation under the skin. His research focuses on improving blood supply using biomaterials and cells to help transplanted islets survive, with the goal of developing a more accessible alternative to the liver for islet transplantation.
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