Islet transplantation, where islets are transplanted into the liver of selected adults with type 1 diabetes with problematic glycemic control, is an evidence-based procedure that prevents severe hypoglycemia (SH), stabilizes glycemic control, and improves quality of life (1–3). Following isolation, pancreatic islets, initially avascular, are transplanted via intraportal infusion, where they embed within the hepatic sinusoids and undergo gradual revascularization through the hepatic arterial system over several weeks. This process, known as engraftment, is critical for clinical success, with outcomes closely associated with the engrafted functional β-cell mass (4,5).
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