ABSTRACT
Islet transplantation has been an evolving technology for the treatment of type 1 diabetes since an enzymatic method of islet isolation from the rat pancreas was described in 1967. Following the description of this method of rat islet isolation, its application in the isolation of human islets was not effectively developed until the Ricordi technique appeared in 1988. Thus, the Ricordi technique provided the springboard for clinical islet transplantation as we know it today. It is widely known, however, that clinical islet transplantation is still a work in progress. More efficient isolation techniques that would enhance islet yield from its present dismal rate using the enzymatic tissue digestion procedure are still needed. Additional obstacles to routine clinical application of islet transplantation include a severe shortage of human islets, the need to use risky immunosuppressive drugs to prevent transplant rejection, and the fact that the optimal site of transplantation is yet to be determined. This chapter provides an overview of the need for further development of this treatment modality before it becomes a routine clinical procedure. Specifically, it reviews the limitations of the standard islet isolation procedure and potential strategies to enhance islet yield, viability, and function. In addition, this chapter discusses the barriers to clinical application and various strategies and biomaterials to improve clinical outcomes.
