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Pancreatic Islet Transplantation Technologies: State of the Art of Micro- and Macro-Encapsulation

  • Cellular Transplants (G Orlando, Section Editor)
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Abstract

Purpose of Review

Type 1 diabetes (T1D) is an autoimmune disease characterized by the loss of insulin-producing cells in pancreatic islets. Despite islet transplantation is effective for selected T1D patients, its widespread application is limited by islet donor shortage and the need for lifelong immunosuppression. Micro- and macro-encapsulation aimed at enveloping cells in a perm-selective biocompatible membrane can potentially eliminate these limitations. This review summarizes tissue-engineering approaches tested in preclinical models of islet transplantation, highlighting technologies currently in the clinic.

Recent Findings

More than 40 years of intensive research raised promises and challenges. Ongoing clinical studies have not yet achieved the desired success as obstacles remained to be overcome: deleterious fibrotic response toward the biomaterial, poor vascularization, insufficient oxygen delivery, and recipient’s immune reaction.

Summary

Only the joint effort of bioengineering, cell biology, and immunology expertises will foster the development of novel, effective, and safe technologies for insulin-producing cell transplantation.

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Abbreviations

IDF:

International Diabetes Federation

T1D:

Type 1 diabetes

CITR:

Collaborative Islet Transplant Registry

UNOS:

United Network for Organ Sharing

SRTR:

Scientific Registry for Transplant Recipients

HbA1c:

Glycated hemoglobin

ECM:

Extracellular matrix

ESC:

Embryonic stem cells

iPSC:

Induced pluripotent stem cells

MSC:

Mesenchymal stem cells

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Authors and Affiliations

  1. Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Elisa Cantarelli, Antonio Citro & Lorenzo Piemonti

  2. Vita- Salute University, Milan, Italy

    Lorenzo Piemonti

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  1. Elisa Cantarelli
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Cantarelli, E., Citro, A. & Piemonti, L. Pancreatic Islet Transplantation Technologies: State of the Art of Micro- and Macro-Encapsulation. Curr Transpl Rep 4, 169–183 (2017). https://doi.org/10.1007/s40472-017-0154-9

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