Intraportal islet transplantation has proven to be efficacious in preventing severe hypoglycemia and restoring insulin independence in selected patients with type 1 diabetes. Multiple islet infusions are often required to achieve and maintain insulin independence. Many challenges remain in clinical islet transplantation, including substantial islet cell loss early and late after islet infusion. Contributions to graft loss include the instant blood-mediated inflammatory reaction, potent host auto- and alloimmune responses, and beta cell toxicity from immunosuppressive agents. Protective strategies are being tested to circumvent several of these events including exploration of alternative transplantation sites, stem cell-derived insulin producing cell therapies, co-transplantation with mesenchymal stem cells or exploration of novel immune protective agents. Herein, we provide a brief introduction and history of islet cell transplantation, limitations associated with this procedure and methods to alleviate islet cell loss as a means to improve engraftment outcomes.

门静脉内胰岛移植已被证明可以有效预防某些 1 型糖尿病患者的严重低血糖并恢复胰岛素独立性。通常需要多次胰岛输注才能实现和维持胰岛素独立性。临床胰岛移植仍存在许多挑战，包括胰岛输注后早期和晚期的大量胰岛细胞损失。导致移植物损失的因素包括即时血液介导的炎症反应、有效的宿主自身和同种免疫反应以及免疫抑制剂产生的β细胞毒性。正在测试规避其中一些事件的保护策略，包括探索替代移植位点、干细胞衍生的胰岛素产生细胞疗法、与间充质干细胞的共移植或探索新型免疫保护剂。在此，我们提供胰岛细胞移植的简要介绍和历史、与该手术相关的局限性以及减轻胰岛细胞损失的方法，作为改善植入结果的手段。