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Clinical and Developmental Immunology
Volume 2013 (2013), Article ID 352315, 13 pages
Review Article

Revascularization of Transplanted Pancreatic Islets and Role of the Transplantation Site

1Clinical Islet Transplant Program, University of Alberta, Edmonton, AB, Canada T6G 2C8
2Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2C8
3Medicine and Surgical Oncology, Clinical Islet and Living Donor Liver Transplant Programs, Alberta Innovates-Healthcare Solutions (AIHS), University of Alberta, 2000 College Plaza, 8215-112th Street, Edmonton, AB, Canada T6G 2C8

Received 10 June 2013; Accepted 9 August 2013

Academic Editor: Palmina Petruzzo

Copyright © 2013 Andrew R. Pepper et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Since the initial reporting of the successful reversal of hyperglycemia through the transplantation of pancreatic islets, significant research efforts have been conducted in elucidating the process of revascularization and the influence of engraftment site on graft function and survival. During the isolation process the intrinsic islet vascular networks are destroyed, leading to impaired revascularization after transplant. As a result, in some cases a significant quantity of the beta cell mass transplanted dies acutely following the infusion into the portal vein, the most clinically used site of engraftment. Subsequently, despite the majority of patients achieving insulin independence after transplant, a proportion of them recommence small, supplemental exogenous insulin over time. Herein, this review considers the process of islet revascularization after transplant, its limiting factors, and potential strategies to improve this critical step. Furthermore, we provide a characterization of alternative transplant sites, analyzing the historical evolution and their role towards advancing transplant outcomes in both the experimental and clinical settings.