Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Sep 18, 2025; 15(3): 102383
Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.102383
Islet dimension and its impact on transplant outcome: A systematic review
Sipra Rout, Pravash R Mishra, Appakalai N Balamurugan, Praveen Kumar Ravi
Sipra Rout, Pravash R Mishra, Praveen Kumar Ravi, Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar 751019, Odisha, India
Appakalai N Balamurugan, Wendy Novak Diabetes Institute, Norton Children's Hospital, Norton Healthcare, Louisville, KY 40202, United States
Appakalai N Balamurugan, Division of Pediatric Endocrinology, Department of Pediatrics, Pediatric Research Institute, University of Louisville, Louisville, KY 40202, United States
Co-corresponding authors: Appakalai N Balamurugan and Praveen Kumar Ravi.
Author contributions: Rout S and Ravi PK conducted the systematic review; Mishra PR and Balamurugan AN supervised the findings of this study; Balamurugan AN and Ravi PK contributed equally to this study as co-corresponding authors; Balamurugan AN provided the relevant photomicrograph to support the data; Ravi PK proposed to investigate the impact of islet size on the transplant outcome; all the authors discussed the results, and contributed to and approved the final manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Praveen Kumar Ravi, MD, DNB, Assistant Professor, Department of Anatomy, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, Odisha, India. praveenkumar1059@gmail.com
Received: October 15, 2024
Revised: February 19, 2025
Accepted: February 27, 2025
Published online: September 18, 2025
Processing time: 184 Days and 14.2 Hours
Core Tip

Core Tip: This systematic review examines the impact of islet size on transplantation outcomes in clinical and preclinical studies. Small islets (< 125 µm) demonstrate superior viability, glucose-stimulated insulin secretion, and engraftment post-transplantation compared to large islets, which suffer from hypoxic injury and poor viability. However, large islets, essential for maintaining euglycemia in vivo, require improved preservation techniques to enhance their post-isolation survival and function. Optimizing islet size and preservation could significantly improve the success of islet transplantation and insulin independence.