Fig. 1.

Timeline of transplanted islet engraftment. Islets require a period of weeks to become engrafted within host tissue. Immediately following implantation, islets are avascular and isolated from host tissue in an inflammatory environment. Islet cells are stressed at this early phase and may undergo anoikis, apoptosis and necrosis as a result of the foreign ECM and inadequate oxygenation and nutrient/waste exchange. ECM remodelling and angiogenesis in the transplant microenvironment and islet tissue are key parts of the islet engraftment process. The figure illustrates and describes the timeline of islet engraftment in host tissue from implantation to long-term maintenance, detailing the changes occurring in the transplant microenvironment and within islets, and challenges to function and survival. The understanding of this process enables the identification of opportunities for enhancing islet engraftment, survival and function throughout the process. These opportunities for enhancement and ways to achieve them are discussed in detail in the article text