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What Is Islet Cell Transplantation?

Islet cell transplantation transfers insulin-producing pancreatic islets into a recipient, most commonly by infusing the cells into the liver through the portal vein. In allogeneic islet transplantation, islets come from a deceased donor and are used for selected adults with type 1 diabetes and severe recurrent hypoglycemia. In autologous islet transplantation, a patient's own islets are isolated after total pancreatectomy and returned to the body to preserve insulin production. Donor islet transplantation requires immunosuppression, while autologous transplantation does not cause immune rejection because the cells come from the same patient.

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What Is Islet Cell Transplantation?

Islet cell transplantation transfers insulin-producing pancreatic islets into a recipient, most commonly by infusing the cells into the liver through the portal vein. In allogeneic islet transplantation, islets come from a deceased donor and are used for selected adults with type 1 diabetes and severe recurrent hypoglycemia. In autologous islet transplantation, a patient's own islets are isolated after total pancreatectomy and returned to the body to preserve insulin production. Donor islet transplantation requires immunosuppression, while autologous transplantation does not cause immune rejection because the cells come from the same patient.

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Why Is Islet Cell Transplantation Performed?

Allogeneic islet transplantation is used for a small group of adults with type 1 diabetes who continue to have repeated severe hypoglycemia and difficulty reaching glucose targets despite intensive diabetes management and education. The Food and Drug Administration approved the first deceased-donor pancreatic islet cellular therapy for this indication in 2023. Autologous islet transplantation is used mainly when the entire pancreas must be removed for severe chronic pancreatitis or another nonmalignant pancreatic condition. The goals are to restore or preserve endogenous insulin secretion, reduce severe hypoglycemia, and decrease dependence on injected insulin when enough transplanted islets survive.

How Is Islet Cell Transplantation Performed?

For allogeneic transplantation, a donor pancreas is processed in a specialized laboratory where pancreatic islets are isolated, purified, counted, and prepared for infusion. A radiologist commonly places a catheter through the abdominal wall into the hepatic portal vein under ultrasound and X-ray guidance, and the islet suspension is infused slowly into the liver. The cells lodge in small liver vessels, establish a new blood supply, and begin releasing insulin in response to blood glucose. Autologous transplantation uses a similar portal-vein infusion after the patient's own pancreas has been removed and processed for islet isolation.

What Is Recovery Like After Islet Cell Transplantation?

Patients are monitored after portal-vein infusion for bleeding, abdominal pain, blood-glucose changes, liver complications, and portal-vein thrombosis. Insulin therapy is usually continued initially while the transplanted islets engraft and their function is assessed. Allogeneic recipients start or continue immunosuppressive medicines and require long-term monitoring for rejection, infection, kidney effects, and islet function. Some patients achieve insulin independence, while others still need insulin but experience better glucose control and fewer episodes of severe hypoglycemia.

What Are the Risks and Complications?

Procedure-related risks include bleeding from the liver puncture, portal-vein thrombosis, abdominal pain, and temporary changes in liver tests. Allogeneic recipients also face the substantial long-term risks of immunosuppressive therapy, including infection, kidney injury, metabolic complications, and certain cancers. Transplanted islet function can decline over time, and more than one donor-islet infusion can be required to achieve adequate insulin production. Autologous transplantation avoids rejection but cannot guarantee insulin independence because the number and quality of recoverable islets vary.

Frequently Asked Questions About Islet Cell Transplantation

Where are transplanted pancreatic islets placed?

The islets are most commonly infused into the hepatic portal vein, where they lodge within the liver and begin establishing a blood supply.

Who qualifies for donor islet transplantation in the United States?

Current FDA-approved therapy is for selected adults with type 1 diabetes who have repeated severe hypoglycemia and cannot approach target glucose control despite intensive management and education.

What is the difference between allogeneic and autologous islet transplantation?

Allogeneic islets come from a deceased donor and require immunosuppression. Autologous islets come from the patient's own removed pancreas and do not require anti-rejection treatment.

Does islet transplantation always eliminate the need for insulin?

No. Some recipients become insulin independent, while others continue insulin but can gain more stable glucose control and fewer episodes of severe hypoglycemia.

References

Current issues in allogeneic islet transplantation. PubMed. https://pubmed.ncbi.nlm.nih.gov/28692442/. Date Accessed September 11, 2026.

FDA Approves First Cellular Therapy to Treat Patients with Type 1 Diabetes. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-first-cellular-therapy-treat-patients-type-1-diabetes. Date Accessed September 11, 2026.

LANTIDRA. U.S. Food and Drug Administration. https://www.fda.gov/vaccines-blood-biologics/lantidra. Date Accessed September 11, 2026.

Pancreatic Islet Transplantation. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/insulin-medicines-treatments/pancreatic-islet-transplantation. Date Accessed September 11, 2026.

Total Pancreatectomy With Islet Autotransplantation for Acute Recurrent and Chronic Pancreatitis. PubMed. https://pubmed.ncbi.nlm.nih.gov/28895017/. Date Accessed September 11, 2026.