Spatially controlled Islet delivery into a bioengineered vascular Niche improves subcutaneous transplantation

Pancreatic islet transplantation represents a promising therapeutic strategy for type 1 diabetes (T1D). In this context, the subcutaneous space offers a safer and more accessible alternative to the clinically established intraportal delivery route. However, a major unmet need remains the development of a site capable of supporting rapid vascularization and sustained islet function. In its current configuration, this approach is limited by poor vascularization, hypoxia-driven islet loss, loss of spatial control during graft delivery, and tissue disruption associated with delivery strategies. To address these challenges, the Neovascularized Implantable Cell Homing and Encapsulation (NICHE) device provides a prevascularized subcutaneous platform that supports islet viability and enables localized immunosuppressant delivery. In this study, we describe the incorporation of a 3D-printed removable placeholder into the NICHE platform to preserve a defined cavity within the device during prevascularization and enable subsequent islet delivery. The placeholder shapes the spatial organization of vascularized tissue, promoting uniform three-dimensional islet distribution upon transplantation. Surface characterization showed that polyamide and BioMed Clear resin exhibit distinct cell adhesion properties, enabling controlled tissue integration and atraumatic placeholder removal. Collectively, these results are consistent with preservation of vascularization, improved islet dispersion within the cell reservoir, reduced inflammatory cell infiltration, and support of metabolic function compared to injection-based delivery. These findings establish spatially controlled cell delivery within a prevascularized niche as a key design principle for enhancing engraftment efficiency and advancing the translational potential of subcutaneous islet transplantation for T1D and related cell-based therapies.