Subcutaneous device-free islet transplantation

Front Immunol. 2023 Oct 18:14:1287182. doi: 10.3389/fimmu.2023.1287182. eCollection 2023.


Diabetes mellitus is a chronic metabolic disease, characterized by high blood sugar levels; it affects more than 500 million individuals worldwide. Type 1 diabetes mellitus (T1DM) is results from insufficient insulin secretion by islets; its treatment requires lifelong use of insulin injections, which leads to a large economic burden on patients. Islet transplantation may be a promising effective treatment for T1DM. Clinically, this process currently involves directly infusing islet cells into the hepatic portal vein; however, transplantation at this site often elicits immediate blood-mediated inflammatory and acute immune responses. Subcutaneous islet transplantation is an attractive alternative to islet transplantation because it is simpler, demonstrates lower surgical complication risks, and enables graft monitoring and removal. In this article, we review the current methods of subcutaneous device-free islet transplantation. Recent subcutaneous islet transplantation techniques with high success rate have involved the use of bioengineering technology and biomaterial cotransplantation-including cell and cell growth factor co-transplantation and hydrogel- or simulated extracellular matrix-wrapped subcutaneous co-transplantation. In general, current subcutaneous device-free islet transplantation modalities can simplify the surgical process and improve the posttransplantation graft survival rate, thus aiding effective T1DM management.

Keywords: diabetes mellitus; extracellular matrix; extracellular matrix diabetes mellitus; hydrogel; islet viability matrix; subcutaneous islet transplantation.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 1* / metabolism
  • Diabetes Mellitus, Type 1* / surgery
  • Humans
  • Insulin / metabolism
  • Islets of Langerhans Transplantation* / adverse effects
  • Islets of Langerhans Transplantation* / methods
  • Islets of Langerhans* / metabolism
  • Subcutaneous Tissue / metabolism


  • Insulin

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This paper was supported by the 2021 Doctoral Research Startup Fund of Guangxi University of Chinese Medicine [grant numbers 2021BS034, 2021BS035], the Guangxi Science and Technology Base and Talent Project [grant number AD22035122] and Funding for Chinese Medicine Service System and Capacity Building (Key Project with Chinese Medicine Characteristics and Advantages, Ruikang Hospital, 2023).