COVID‐19 and islet transplantation: different twins

Piemonti, Lorenzo; Landoni, Giovanni

For those who work in the field of islet transplantation, the micro vascular COVID‐19 lung vessels obstructive thrombo‐inflammatory syndrome (recently referred to as MicroCLOTS) is familiar, as one cannot fail to recognize the presence of similarities with the instant blood mediated inflammatory reaction (IBMIR) occurring in the liver hours and days after islet infusion. Evidences in both MicroCLOTS and IBMIR suggest the involvement of the coagulation cascade and complement system activation, and proinflammatory chemokines/cytokines release. Identification and targeting of pathway(s) playing a role as “master regulator(s)” in the post‐islet transplant detrimental inflammatory events could be potentially useful to suggest innovative COVID‐19 treatments and vice versa. All the scientific organizations across the world are fighting the COVID‐19 pandemic. Islet transplantation, and more generally the transplantation scientific community, could contribute suggesting strategies for innovative approaches. At the same time, in the near future, clinical trials in COVID‐19 patients will produce an enormous quantity of clinical and translational data on the control of inflammation, and complement/microthrombosis activation. These data will represent a legacy to be transformed into innovation in the transplant field. It will be our contribution to change a dramatic event into advancement for the transplant field, and ultimately for our patients.