New approaches for successful islet transplantation.

The long-term control of glucose metabolism is expected to be achieved with insulin-secreting pancreatic islets transplanted as the whole pancreas or isolated islet tissue. The current clinical outcomes of such procedures are unsatisfactory compared with that of whole organ transplantation or experimental islet transplantation, although the safety of the transplantation procedure itself is assured. In this review, we first describe the immunological characteristics of purified islets in an attempt to explain the differences between the results for human and experimental islet transplantation. We then introduce new approaches currently undertaken in our laboratory that could, we hope, make islet transplantation more successful.