Table 2: Summary of advantages and disadvantages of various transplant sites that have been evaluated for human islet transplant.
Site | Advantage | Disadvantage |
---|---|---|
Intraliver | Good vascular supply. | Vessel aneurysm, thrombosis. Acute steatosis. Incorrect inhibition of glucagon release of transplanted islets. Limited volume of islets possible. |
Spleen | Better islet survival and success rate of diabetes reversal in animal models. Avoids hyperinsulinemia. |
Abnormal glucagon response during hypoglycemic eposides. |
Omentum | Easy surgical accessibility. Can accommodate larger volume of islets. Avoids hyperinsulinemia. |
Abnormal glucagon response during hypoglycemic eposides. |
Intramuscular | Good vascularization in the absence of suitable intraliver transplant. | Limited volume of islets. Limited evidence of long term success. |
Peritoneal cavity | Very large capacity, especially for encapsulated islet transplant. | Delay in systemic insulin distribution. Larger number of islets needed to provide blood glucose control. |
Subcutaneous space | Easy to access. | Limited data on non-encapsulated islet transplant. Lack of good immediate vascular supply. |