Pancreatic islet cell transplant.

It is obvious that islet transplantation as an isograft can produce normoglycemia and can prevent and reverse early complications of diabetes in rodents. It is possible to produce normoglycemia in immunosuppressed diabetic patients with human islet transplants. It is possible to prevent rejection of islets in animals without continuous immunosuppression by immunoalteration of the islets, and this approach will be attempted in human diabetes. Finally, the encapsulation approach for prevention of rejection of islets is promising. Large animals will be used to test prototypes of the hollow fibers for humans, and if these experiments are successful, it will be possible to progress rapidly to human diabetes. The first approach with encapsulation in human diabetes would be to use human islets, then encapsulated pig islets, and finally genetically engineered beta cell lines when they become available. I hope that these approaches in islet transplantation will prevent the devastating diabetic complications that Henry Dolger demonstrated many years ago could occur in diabetic patients even though those patients are taking insulin.