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Cited by 350Pancreatic function and diabetesDiabetes and associated disordersTransplantation: Methods and Outcomes

Potent Induction Immunotherapy Promotes Long-Term Insulin Independence After Islet Transplantation in Type 1 Diabetes

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Bellin, M.D., Barton, F.B., Heitman, A., Harmon, J.V., Kandaswamy, R., Balamurugan, A.N., Sutherland, D.E.R., Alejandro, R. +1 more·2012·American Journal of Transplantation
DOI 10.1111/j.1600-6143.2011.03977.xPMC PMC3390261
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Abstract

The seemingly inexorable decline in insulin independence after islet transplant alone (ITA) has raised concern about its clinical utility. We hypothesized that induction immunosuppression therapy determines durability of insulin independence. We analyzed the proportion of insulin-independent patients following final islet infusion in four groups of ITA recipients according to induction immunotherapy: University of Minnesota recipients given FcR nonbinding anti-CD3 antibody alone or T cell depleting antibodies (TCDAb) and TNF-α inhibition (TNF-α-i) (group 1; n = 29); recipients reported to the Collaborative Islet Transplant Registry (CITR) given TCDAb+TNF-α-i (group 2; n = 20); CITR recipients given TCDAb without TNF-α-i (group 3; n = 43); and CITR recipients given IL-2 receptor antibodies (IL-2RAb) alone (group 4; n = 177). Results were compared with outcomes in pancreas transplant alone (PTA) recipients reported to the Scientific Registry of Transplant Recipients (group 5; n = 677). The 5-year insulin independence rates in group 1 (50%) and group 2 (50%) were comparable to outcomes in PTA (group 5: 52%; p>>0.05) but significantly higher than in group 3 (0%; p = 0.001) and group 4 (20%; p = 0.02). Induction immunosuppression was significantly associated with 5-year insulin independence (p = 0.03), regardless of maintenance immunosuppression or other factors. These findings support potential for long-term insulin independence after ITA using potent induction therapy, with anti-CD3 Ab or TCDAb+TNF-α-i.

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Cited by

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Authors
Bellin, M. D., Barton, F. B., Heitman, A., Harmon, J. V., Kandaswamy, R., Balamurugan, A. N., Sutherland, D. E. R., Alejandro, R., & Hering, B. J.
Affiliations
  • University of Minnesota (US)
  • Emmes (United States) (US)
  • University of Miami (US)
Corresponding author
Bellin, M.D.
ORCID
Venue
American Journal of Transplantation
Publisher
Elsevier BV
Published
2012-06
Volume
12
Issue
6
Pages
1576-1583
ISSN
1600-6135 (ISSN-L)
DOI
10.1111/j.1600-6143.2011.03977.x
PMC
PMC3390261
OpenAlex
W2137464815
Cited by
350
References
1
Citations by year
2026: 6 · 2025: 11 · 2024: 13 · 2023: 15 · 2022: 16 · 2021: 32 · 2020: 26 · 2019: 37 · 2018: 30 · 2017: 18 · 2016: 51 · 2015: 29 · 2014: 30 · 2013: 24 · 2012: 12
FWCI
31.02
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Transplantation (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • University of Minnesota (MO1-RR00400)
  • National Institutes of Health (5u42rr016598-08, MO1‐RR00400, RR00400)
  • Health Resources and Services Administration
  • National Institute of Allergy and Infectious Diseases (U01AI065193, 5U01 AI-065193)
  • National Institute of Diabetes and Digestive and Kidney Diseases (DK56963, K23DK084315, R01DK056963)
  • National Center for Research Resources (U42 RR016598-01, M01RR000400, MO 1 RR00400, U42-RR016598)
Topics
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
Keywords
islet transplantation, type 1 diabetes, induction immunosuppression, insulin independence, anti-CD3 antibody, anti-TNF therapy, pancreas transplantation, graft survival
MeSH terms
Diabetes Mellitus, Type 1, Humans, Immunotherapy, Islets of Langerhans Transplantation

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