A biologic resorbable scaffold for tissue engineering of the endocrine pancreas: Clinical experience of islet transplantation on the omentum

Abstract Islet transplantation (ITx) is a cellular therapy that has demonstrated efficacy in improving glycemic control and abolishing hypoglycemia in patients affected by type 1 diabetes complicated by hypoglycemia unawareness and episodes of severe hypoglycemia. Although the intrahepatic site is the only clinical site that has shown long-term islet allograft engraftment with achievement of insulin independence, it remains far from being an ideal transplantation site. In this chapter, we have described our clinical experience with ITx within a biodegradable scaffold transplanted onto an extravascular site, the omentum, through laparoscopic surgery. We have provided metabolic data showing efficacy and described the challenges associated with this approach. These encouraging initial results and the unique advantages offered by an extravascular site prompt the need for further evaluation of this transplantation technique. The development of strategies to improve local oxygen delivery, to promote graft neovascularization, and to minimize immunosuppression are required to improve long-term outcomes at this novel transplant site.