Influence of islet purity on the proportion of smaller islets and graft outcomes in clinical transplantation.

Authors

Praveen Kumar Ravi, Sipra Rout, Pravash R Mishra, Appakalai N Balamurugan

Published in

World journal of transplantation. Volume 16. Issue 2. Pages 116413. Jun 18, 2026.

Abstract

The outcome of clinical islet transplantation has been influenced by various factors, including the volume of islet transplanted (IEQ), frequency of transplantation, islet size, and purity. Most studies have compared the outcomes with these factors individually. This review attempts to comprehend the key factors that influence the outcome of clinical islet transplantation by understanding and analyzing the relationship between them. The purity of the islet preparation is often overlooked, as it is often believed to have a higher level of purity associated with better clinical outcome. However, a recent study documented long-term outcome of transplantation is better when purity less than 50%. Various studies have documented the decrease in the proportion of small islets with an increase in purity. Poor clinical outcomes have been documented when the transplanted islet preparation contains a lower proportion of small islets. This is not only because small islets survive better with diffusion, but also the higher proportion of large islets is prone to producing overestimation in IEQ calculation, leading to inadequate transplantation volume. Vigorous purification processes may remove the potential stem cells or progenitor cells present in pancreas and lack the paracrine effect that supports the viability and function of transplanted islets.

PMID:
42281864
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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