A comparative analysis of the safety, efficacy, and cost of islet versus pancreas transplantation in nonuremic patients with type 1 diabetes
Open accessAbstract
Few current studies compare the outcomes of islet transplantation alone (ITA) and pancreas transplantation alone (PTA) for type 1 diabetes (T1D). We examined these two beta cell replacement therapies in nonuremic patients with T1D with respect to safety, graft function and cost. Sequential patients received PTA (n = 15) or ITA (n = 10) at our institution. Assessments of graft function included duration of insulin independence; glycemic control, as measured by hemoglobin A1c; and elimination of severe hypoglycemia. Cost analysis included all normalized costs associated with transplantation and inpatient management. ITA patients received one (n = 6) or two (n = 4) islet transplants. Mean duration of insulin independence in this group was 35 mo; 90% were independent at 1 year, and 70% were independent at 3 years. Mean duration of insulin independence in PTA was 55 mo; 93% were insulin independent at 1 year, and 64% were independent at 3 years. Glycemic control was comparable in all patients with functioning grafts, as were overall costs ($138 872 for ITA, $134 748 for PTA). We conclude that with advances in islet isolation and posttransplant management, ITA can produce outcomes similar to PTA and represents a clinically viable option to achieve long-term insulin independence in selected patients with T1D.
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Subsequent transplantation studies showed improved patient outcomes, with islet transplantation approaching the success of whole pancreas transplantation without the corresponding surgical risk.
“Subsequent transplantation studies continued to show improved patient outcomes, with islet transplantation approaching the success of whole pancreas transplantation without the corresponding surgical risk.18–23”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [21]
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Untitled work
Diabetes Canada Clinical Practice Guidelines Expert Committee (n.d.) · Diabetes Canada
- Authors
- Moassesfar, S., Masharani, U., Frassetto, L. A., Szot, G. L., Tavakol, M., Stock, P. G., & Posselt, A. M.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Posselt, A.M.
- Venue
- American Journal of Transplantation
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 16
- Issue
- 2
- Pages
- 518-526
- ISSN
- 1600-6135 (ISSN-L)
- PMC
- PMC5549848
- OpenAlex
- W2172305142
- Cited by
- 80
- References
- 28
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 6 · 2023: 7 · 2022: 4 · 2021: 9 · 2020: 5 · 2019: 15 · 2018: 12 · 2017: 9 · 2016: 7 · 2015: 1
- FWCI
- 9.68
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Transplantation (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
- Funders
- Juvenile Diabetes Research Foundation International (4-2004-372)
- National Institutes of Health (T32DK007161-40, 5K12DK094726-04)
- Chesapeake Research Consortium (UL1 RR024131)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- islet transplantation, pancreas transplantation, type 1 diabetes, insulin independence, glycemic control, hypoglycemia, graft function, transplant costs, beta cell replacement therapy
- MeSH terms
- Adult, Cost-Benefit Analysis, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Glomerular Filtration Rate, Graft Rejection, Graft Survival, Humans, Kidney Function Tests, Length of Stay, Male, Middle Aged, Prognosis, Risk Factors, Safety, Pancreas Transplantation, Islets of Langerhans Transplantation
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