combined strategy of endothelial cells coating sertoli cells coculture and infusion improves vascularization and rejection protection of islet graft improving islet graft revascularization and inhibiting rejection become crucial tasks for prolonging islet graft survival endothelial cells ecs are the basis of islet vascularization and sertoli cells scs have the talent to provide nutritional support and exert immunosuppressive effects we construct a combined strategy of ecs coating in the presence of nutritious and immune factors supplied by scs in a coculture system to investigate the effect of vascularization and rejection inhibition for islet graft in vivo the combined strategy improved the survival and vascularization as well as inhibited lymphocytes and inflammatory cytokines in vitro we found the combinatorial strategy improved the function of islets and the effect of ecscoating on islets combined strategy treated islets revealed higher levels of antiapoptotic signal molecules bcl2 and hsp32 survival and function related molecules pdx1 ki67 erk12 and akt and demonstrated increased vascular endothelial growth factor receptor 2 kdr and angiogenesis signal molecules fak and plc scs effectively inhibited the activation of lymphocyte stimulated by islets and ecs predominantly immunosuppressive cytokines could be detected in culture supernatants of the scs coculture group these results suggest that ecscoating and sertoli cells coculture or infusion synergistically enhance islet survival and function after transplantation