[2] If the cells are not from a genetically identical donor the person's body will recognize them as foreign and the immune system will begin to attack them as with any transplant rejection.

[5] Donislecel (Lantidra) allogeneic (donor) pancreatic islet cellular therapy was approved for medical use in the United States in June 2023.

[citation needed] While significant progress has been made in the islet transplantation field,[10] many obstacles remain that currently preclude its widespread application.

Current immunosuppressive regimens are capable of preventing islet failure for months to years, but the agents used in these treatments are expensive and may increase the risk for specific malignancies and opportunistic infections.

Further, like all medications, the agents have other associated toxicities, with side effects such as oral ulcers, peripheral edema, anemia, weight loss, hypertension, hyperlipidemia, diarrhea and fatigue.

For the person with diabetes, renal function is a crucial factor in determining long-term outcome, and calcineurin inhibitors (tacrolimus and ciclosporin) are significantly nephrotoxic.

Indeed, Ojo et al. have published an analysis indicating that among people receiving other-than-kidney allografts, 7%–21% end up with kidney failure as a result of the transplant and/or subsequent immunosuppression.

Dr. Melena Bellin is an associate professor of pediatric endocrinology and surgery and director of research for the islet autotransplant program at the University of Minnesota Medical Center and Masonic Children's Hospital.

Losing islet cells decreases the probability of successful insulin production and increases the likelihood of type one diabetes developing again in the patient.