Current Diabetes Reports

, Volume 13, Issue 5, pp 687–694 | Cite as

Transplantation of Xenogeneic Islets: Are We There Yet?

  • Philip J. O’Connell
  • Peter J. Cowan
  • Wayne J. Hawthorne
  • Shounan Yi
  • Andrew M. Lew
Transplantation (A Pileggi, Section Editor)


Beta cell replacement therapy has been proposed as a novel therapy for the treatment of type 1 diabetes. The proof of concept has been demonstrated with successful islet allotransplantation. Islet xenotransplantation has been proposed as an alternative, more reliable, and infinite source of beta cells. The advantages of islet xenotransplantation are the ability to transplant a well differentiated cell that is responsive to glucose and the potential for genetic modification which focuses the treatment on the donor rather than the recipient. The major hurdle remains overcoming the severe cellular rejection that affects xenografts. This review will focus on the major advances that have occurred with genetic modification and the successful therapeutic strategies that have been demonstrated in nonhuman primates. Novel approaches to overcome cell-mediated rejection including biological agents that target selectively costimulation molecules, the development of local immunosuppression through genetic manipulation, and encapsulation will be discussed. Overall, there has been considerable progress in all these areas, which eventually should lead to clinical trials.


Transplantation Xenogeneic islets Type 1 diabetes Islet xenotransplantation 


Compliance with Ethics Guidelines

Conflict of Interest

Philip J. O’Connell declares that he has no conflict of interest.

Peter J. Cowan has received grant support from National Health & Medical Research Council of Australia; Juvenile Diabetes Research Foundation (Program Grant #447718: Which transgenic pig will be used for islet transplantation in humans?).

Wayne J. Hawthorne declares that he has no conflict of interest.

Shounan Yi declares that he has no conflict of interest.

Andrew M. Lew has received grant support from National Health & Medical Research Council and Juvenile Diabetes Research Foundation for diabetes research. He has also received support in kind such as writing, provision of medicines or equipment, or administrative support from Victorian state government for support for infrastructure costs.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Philip J. O’Connell
    • 1
  • Peter J. Cowan
    • 2
    • 3
  • Wayne J. Hawthorne
    • 1
  • Shounan Yi
    • 1
  • Andrew M. Lew
    • 4
  1. 1.Centre for Transplant and Renal Research, Westmead Millennium InstituteUniversity of Sydney at Westmead HospitalWestmeadAustralia
  2. 2.Immunology Research CentreSt Vincent’s HospitalMelbourneAustralia
  3. 3.Department of MedicineUniversity of MelbourneMelbourneAustralia
  4. 4.Walter and Eliza Hall Institute of Medical ResearchParkvilleAustralia

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