Elliott first became interested in the potential of xenotransplantation for diabetes during his paediatric medicine training, over 40 years ago. He was involved in some experimental research even then, looking at transplanting rat islets to the anterior chamber of the eye - an immune-privileged site - of diabetic rabbits.

He kept an eye on ongoing research in human foetal islets while he did further training in Colorado, and after he moved to the University of Auckland in 1970, but it wasn't until the mid-80s that practical interest resurfaced.

This was when he met a businessman called David Collinson, who had a son with diabetes and had come looking for answers. Together, they set up LCT and have been working on perfecting porcine islet transplantation ever since.

"There are never going to be enough human islets so it would have to be animal islets, and if it is animal islets somehow they have got to be done without immune suppressants," he says.

"With those two things in mind, we initially tried to get islets from unborn pigs, just before term, and transplanting those into a variety of animals. We were using a non-immuno-suppressant called nicotinamide, which arrests the immediate immune response, with a small degree of success."

While on study leave in Germany in 1991 he met a researcher who recommended alginate encapsulation as a way to avoid immune rejection, so he began looking around for people doing work in that area.

LCT became involved with a Californian research group and used their encapsulation technology, along with LCT's cells, in early trials, including the one Michael Helyer was involved in. Then to Mexico, where a group was experimenting with Sertoli cells from the testis, which produce a local immuno-suppression effect.

It was a group from the University of Perugia in Italy, however, led by Professor Riccardo Calafiore, that turned out the most promising. This group has found a way to purify alginate to make smooth, long surviving capsules without surface pitting, meaning the cells inside are not exposed.

LCT and the Perugia team work closely together and have recently published details of their methods in the Journal of Biomedical Materials Research Part A.

"They didn't have patents, as they were old-fashioned academics who worked their butts off getting the stuff made," Elliott says.

"We have subsequently taken out a patent that is an improvement on the original method. The standardisation of materials and the way you go about doing it - we put a lot of work into making sure it would be the same each time we did it. We needed to get it dead right."

So have they got it dead right? The proof of the pudding is in the eating and LCT is getting good results, Elliott says.

"There is room for improvement and that's going on consistently. There are all sorts of issues turning up, like how long do you keep the cells in culture before you put them in.

"Initially we thought the quicker the better because they don't go too well when you culture for a long period of time. But after encapsulation they last quite well and they seem to improve in the first couple of weeks."

No one quite knows how long the capsules and their precious contents remain productive in the body, but Michael Helyer is proof that a decade is not out of the question.

Elliott says those surviving islets were probably the hardiest survivors, but considering that the technology used at the time was quite poor, it looks promising. "How long that will go on I don't know, but the prospects are that with the technology we have now they will last as long as they would in a pig. A pig lives for about 20 years."

So, onwards to clinical trials. Six patients will be involved in Russia and eight in New Zealand, with the Russian patients receiving two half-doses six months apart. The New Zealand patients will be split into two groups of four, one of which will receive double the dose of the Russian patients and the other triple.

The primary endpoints of the trials are safety and efficacy, and to ensure the procedure is worthwhile. The cells must remain productive for more than six months, but preferably more than 12 months, to make the procedure economically viable.

In LCT's favour for moving the trials along quickly, however, is the fact they involve transplants, not pharmaceuticals. "We are following the methods used for drug trials, but this is not a drug: it's a transplant procedure," Elliott says.

"Transplant trials are not carried out that way - they don't go through Phase I, II and III. My suspicion is that this will never go through those phases - it will be a number of pilot studies, some larger pivotal studies and it will be free for all after that."