Type 1 diabetes has been successfully treated by transplanting islets of Langerhans (islets), endocrine tissue releasing insulin. Serious issues, however, still remain. The administration of immunosuppressive drugs is required to prolong graft functioning; however, side effects of their long-term use on recipients are not fully understood, and cell transplantation therapy without the use of immunosuppressive drugs is desired. To resolve these issues, the encapsulation of isles with a semi-permeable membrane, or bioartificial pancreas, has been attempted. Many groups have reported that it functions very well in small animal models. Few of the bioartificial pancreases, however, were applied to human patients and their clinical outcome was not clear. In this review, we address obstacles and overview new techniques to overcome these issues, such as conformal coating and islet enclosure with cells.
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