Clinical islet transplantation at the University of California, San Francisco.

The UCSF clinical islet transplant program has evolved to utilize immunosuppressive strategies that do not rely on CNIs or other nephro- and beta-cell-toxic immunosuppressive agents. These novel strategies depend on lymphocyte-depleting induction immunotherapy and maintenance immunosuppression with novel agents that focus on co-stimulation and/or lymphocyte migration blockade. These drugs are well tolerated, frequently allow establishment of insulin independence after single islet infusions, and minimize allosensitization. Our early results suggest these regimens will be attractive immunosuppressive agents for future protocols in allogeneic islet transplantation as well as protocols utilizing stem-cell-derived beta cells.