Abstract
Though islet transplantation is now being considered as a gold standard to cure type 1 diabetes in patients without the threat of unaware hypoglycemia and severe hypoglycemia episode, post-transplantation islet loss due to the loss of intra-islet vasculature during the islet isolation process compromises the full functionality of the transplanted islet mass. Therefore, besides instant blood-mediated inflammatory reaction (IBMIR) induced loss within the first 60 minutes in intraportal vein, two weeks avascular window, prior to adequate vascularization, is responsible for further loss of islets due to hypoxia induced necrosis. Burgeoning evidences demonstrated that using omentum or kidney capsules we can overcome the IBMIR. This review first summarizes the post -transplantation islet loss till day 14 due to the absence of islet vascularization and then elucidates the methods used to restore the post-IBMIR islet loss. Co-transplantation of mesenchymal stem cells and endothelial cells with the islets appeared to be a better approach to overcome the challenges in islet transplantation.