Ten-Year Outcome of Islet Alone or Islet After Kidney Transplantation in Type 1 Diabetes: A Prospective Parallel-Arm Cohort Study
Open accessAbstract
Objective The long-term outcome of allogenic islet transplantation is unknown. The aim of this study was to evaluate the 10-year outcome of islet transplantation in patients with type 1 diabetes and hypoglycemia unawareness and/or a functioning kidney graft. Research design and methods We enrolled in this prospective parallel-arm cohort study 28 subjects with type 1 diabetes who received islet transplantation either alone (ITA) or after a kidney graft (IAK). Islet transplantation consisted of two or three intraportal infusions of allogenic islets administered within (median [interquartile range]) 68 days (43-92). Immunosuppression was induced with interleukin-2 receptor antibodies and maintained with sirolimus and tacrolimus. The primary outcome was insulin independence with A1C ≤6.5% (48 mmol/mol). Secondary outcomes were patient and graft survival, severe hypoglycemic events (SHEs), metabolic control, and renal function. Results The primary outcome was met by (Kaplan-Meier estimates [95% CI]) 39% (22-57) and 28% (13-45) of patients 5 and 10 years after islet transplantation, respectively. Graft function persisted in 82% (62-92) and 78% (57-89) of case subjects after 5 and 10 years, respectively, and was associated with improved glucose control, reduced need for exogenous insulin, and a marked decrease of SHEs. ITA and IAK had similar outcomes. Primary graft function, evaluated 1 month after the last islet infusion, was significantly associated with the duration of graft fun…
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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 [19]
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- Authors
- Vantyghem, M.-C., Chetboun, M., Gmyr, V., Jannin, A., Espiard, S., Le Mapihan, K., Raverdy, V., Delalleau, N., Machuron, F., Hubert, T., Frimat, M., Van Belle, E., Hazzan, M., Pigny, P., Noel, C., Caiazzo, R., Kerr-Conte, J., Pattou, F., & on behalf of the working groups Diaménord, G.
- Affiliations
- Inserm (FR)
- University of Lille, U1190-EGID, Lille, France
- Centre Hospitalier Universitaire de Lille (FR)
- Department of Endocrinology, Diabetology, and Metabolism, Centre Hospitalier Universitaire de Lille, Lille, France
- Department of Cardiology, Centre Hospitalier Universitaire de Lille, Lille, France
- Department of Nephrology, Centre Hospitalier Universitaire de Lille, Lille, France
- Corresponding author
- Vantyghem, Marie-Christine
- Pattou, François
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2019-10-10
- Volume
- 42
- Issue
- 11
- Pages
- 2042-2049
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2981162268
- Cited by
- 105
- References
- 43
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 10 · 2023: 22 · 2022: 27 · 2021: 20 · 2020: 7 · 2019: 3
- FWCI
- 13.57
- Type
- journal article
- Language
- en
- Update notices
- correction (2020-05-01)
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- LillOA (Université de Lille (University Of Lille)) (submittedVersion, other-oa)
- Funders
- Agence Nationale de la Recherche (ANR-10-LABX-0046)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- islet transplantation, type 1 diabetes, kidney transplantation, Edmonton protocol, hypoglycemia unawareness, insulin independence, graft function, long-term outcomes, rapamycin, tacrolimus, interleukin-2 receptor antibody, renal function
- MeSH terms
- Adult, Blood Glucose, Combined Modality Therapy, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Immunosuppression Therapy, Insulin, Male, Middle Aged, Postoperative Complications, Prospective Studies, Kidney Transplantation, Islets of Langerhans Transplantation, Treatment Outcome
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