Diabetes is a vexing foe. In patients with type 1 diabetes, the ability to produce insulin is severely impaired by the immune system, which destroys insulin-producing islet cells in the pancreas. Replacing the cells is possible thanks to Camillo Ricordi, M.D., scientific director and chief academic officer of the Diabetes Research Institute (DRI), who developed a method for the efficient isolation of islets from the donor pancreas for transplantation.

“Isolated islets are currently transplanted into the liver of patients with diabetes, where they start producing insulin and can restore metabolic control,” says Ricordi. The islets are injected into the portal vein, the main blood vessel into the liver. While the DRI has had great success with that method for decades, there are problems.

“The injection of islet cells into the blood in the portal vein results in the generation of inflammation that compromises their viability,” says Luca Inverardi, M.D., director of immunobiology of islet transplantation at the DRI. “Many of those cells fail.”

A new biomechanical device may eliminate all of the problems that characterize the current transplant site.

It is hollow, with a porous screen mesh and a solid plastic cylinder inside. In experimental models, the device was implanted 40 days before islet transplantation in order to allow blood vessels to grow around and through the chamber, giving it resilience and stability. Then the cylinder was removed, and compatible islet cells were injected into the hollow center. In testing, within hours the islets were producing and delivering insulin through vibrant new blood vessels, production that continued over time.

“ It would be highly desirable to find an alternative to the liver as the site of these transplants,” says Antonello Pileggi, M.D., research professor of surgery at the DRI. “This device is very promising and seems to have long-term reliability in these initial experimental models.”

“Successful reversal of diabetes with this device is quite exciting,” says Ricordi. “It opens the possibility of creating a bio-artificial organ that could replace the current practice of injecting islets into the liver.”

The DRI is currently extending the studies with clinical trials in mind.