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However, the limited availability of human cadaveric islet donors and the need for ongoing administration of immunosuppressive agents post\u2010transplantation hinder the widespread use of this treatment. Stem cell\u2010derived islet organoids have emerged as an effective alternative to primary human islets. Nevertheless, implementing this cell replacement therapy still requires chronic immune suppression, which may result in life\u2010long side effects. To address these challenges, innovations such as encapsulation devices, universal stem cells, and immunomodulatory strategies are being developed to mitigate immune rejection and prolong the function of the transplant. This review outlines the contemporary challenges in pancreatic \u03b2 cell therapy, particularly immune rejection, and recent progress in immune\u2010isolation devices, hypoimmunogenic stem cells, and immune regulation of transplants. 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