Diabetes is a complex disease that affects over 400 million people worldwide. The life-long insulin injections and continuous blood glucose monitoring required in type 1 diabetes (T1D) represent a tremendous clinical and economic burdens that urges the need for a medical solution. Pancreatic islet transplantation holds great promise in the treatment of T1D; however, the difficulty in regulating post-transplantation immune reactions to avoid both allogenic and autoimmune graft rejection represent a bottleneck in the field of islet transplantation. Cell replacement strategies have been performed in hepatic, intramuscular, omentum, and subcutaneous sites, and have been performed in both animal models and human patients. However more optimal transplantation sites and methods of improving islet graft survival are needed to successfully translate these studies to a clinical relevant therapy. In this review, we summarize the current progress in the field as well as methods and sites of islet transplantation, including stem cell-derived functional human islets. We also discuss the contribution of immune cells, vessel formation, extracellular matrix, and nutritional supply on islet graft survival. Developing new transplantation sites with emerging technologies to improve islet graft survival and simplify immune regulation will greatly benefit the future success of islet cell therapy in the treatment of diabetes.

糖尿病是一种复杂的疾病，影响着全世界超过 4 亿人。1 型糖尿病 (T1D) 所需的终生胰岛素注射和连续血糖监测代表了巨大的临床和经济负担，迫切需要一种医疗解决方案。胰岛移植在治疗 T1D 方面具有广阔前景；然而，调节移植后免疫反应以避免同种异体和自身免疫移植排斥反应的困难是胰岛移植领域的瓶颈。细胞替代策略已在肝脏、肌肉、网膜和皮下部位进行，并已在动物模型和人类患者中进行。然而，需要更优化的移植部位和提高胰岛移植物存活率的方法才能成功地将这些研究转化为临床相关疗法。在这篇综述中，我们总结了该领域的当前进展以及胰岛移植的方法和部位，包括干细胞衍生的功能性人胰岛。我们还讨论了免疫细胞、血管形成、细胞外基质和营养供应对胰岛移植物存活的影响。利用新兴技术开发新的移植部位以提高胰岛移植物的存活率并简化免疫调节，将极大地有利于胰岛细胞疗法在糖尿病治疗中的未来成功。包括干细胞衍生的功能性人类胰岛。我们还讨论了免疫细胞、血管形成、细胞外基质和营养供应对胰岛移植物存活的影响。利用新兴技术开发新的移植部位以提高胰岛移植物的存活率并简化免疫调节，将极大地有利于胰岛细胞疗法在糖尿病治疗中的未来成功。包括干细胞衍生的功能性人类胰岛。我们还讨论了免疫细胞、血管形成、细胞外基质和营养供应对胰岛移植物存活的影响。利用新兴技术开发新的移植部位以提高胰岛移植物的存活率并简化免疫调节，将极大地有利于胰岛细胞疗法在糖尿病治疗中的未来成功。