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Cited by 15Pancreatic function and diabetesDiabetes Management and ResearchDiabetes and associated disorders

Impact of Islet Transplantation on Diabetes Complications and Mortality in Patients Living With Type 1 Diabetes

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Perrier, Quentin, Jambon-Barbara, Clément, Kessler, Laurence, Villard, Orianne, Buron, Fanny, Guerci, Bruno, Borot, Sophie, Roustit, Matthieu +43 more·2025·Diabetes Care
DOI 10.2337/dc25-0059PMC PMC12094206
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Abstract

OBJECTIVE: This study aimed to evaluate the impact of islet transplantation (IT) on diabetes complications, death, and cancer incidence. RESEARCH DESIGN AND METHODS: This retrospective, multicenter, cohort study included patients from three IT clinical trials (intervention group) and from the French health insurance claims database Système National des Données de Santé (SNDS) (control group). Two cohorts of IT recipients were analyzed: IT recipients after kidney transplantation (IAK) and IT recipients alone (ITA). They were matched with patients living with type 1 diabetes (T1D) from the SNDS using a propensity score. The primary outcome was a composite criterion including death, dialysis, amputation, nonfatal stroke, nonfatal myocardial infarction, and transient ischemic attack. The secondary outcome was cancer. Hazard ratio (HRs) and P values were obtained using Cox proportional hazards analysis and log-rank test, respectively. RESULTS: The study included 61 ITA recipients matched to 610 T1D control patients and 45 IAK recipients matched to 45 T1D control patients over a median follow-up period >10 years. Compared with T1D control patients, ITA and IAK recipients had a lower composite outcome risk (HR 0.39 [95% CI 0.21–0.71; P = 0.002] and 0.52 [0.30–0.88; P = 0.014], respectively) that seemed driven by reduced mortality (0.22 [0.09–0.54]; P < 0.001) for ITA and reduced dialysis (0.19 [0.07–0.50]; P < 0.001) for IAK. Both groups showed no significant changes in cancer risk. CONCLUSIONS: This study suggests long-term benefits of IT on diabetes-related outcomes. Furthermore, despite the use of immunosuppressive drugs following IT, we observed no significant increase in the risk of cancer. Altogether, these findings highlight a favorable risk-benefit ratio of IT in treating patients with unstable T1D.

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  • Islet transplantation reduced mortality compared with kidney transplants and composite negative outcomes including mortality in individuals without kidney transplants.

    “and islet transplantation reduced mortality compared with kidney transplants and composite negative outcomes including mortality in individuals without kidney transplants.66,67”

    From The future of type 1 diabetes therapy (2025) · cites this paper as [67]

    The Results (Table 2; page not supplied) show lower mortality for islet-transplant-alone recipients than for their controls without kidney transplants, and lower composite-outcome risk in both study groups. But mortality was not significantly lower for islet-after-kidney recipients than for kidney-transplant-only controls (HR 0.78, 95% CI 0.38–1.61; P = 0.50). The claim assigns the mortality finding to the wrong comparator. (LLM, conf=0.91)

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  • Recently, islet transplantation after kidney transplantation was associated with superior long-term outcomes to kidney transplantation alone.

    “Recently, islet transplantation after kidney transplantation was associated with superior longterm outcomes to kidney transplantation alone,”

    From The future of type 1 diabetes therapy (2025) · cites this paper as [67]

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References 39 · Cited by 15

Research works printed but not linked: 36

  1. [1]Pease A, Lo C, Earnest A, Kiriakova V, Liew D, Zoungas S. The efficacy of technology in type 1 diabetes: a systematic review, network meta-analysis, and narrative synthesis. Diabetes Technol Ther 2020; 22: 411– 421 31904262
  2. [2]Nathan DM; DCCT/EDIC Research Group. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study at 30 years: overview. Diabetes Care 2014; 37: 9– 16 24356592 PMC3867999
  3. [3]Brennan DC, Kopetskie HA, Sayre PH,. Long-term follow-up of the Edmonton protocol of islet transplantation in the United States. Am J Transplant 2016; 16: 509– 517 26433206
  4. [4]Vantyghem M-C, Chetboun M, Gmyr V,. Erratum. Ten-year outcome of islet alone or islet after kidney transplantation in type 1 diabetes: a prospective parallel-arm cohort study. Diabetes Care 2019;42:2042-2049. Diabetes Care 2020; 43: 1164– 2049 31615852
  5. [5]Lablanche S, Borot S, Wojtusciszyn A,.; GRAGIL Network. Ten-year outcomes of islet transplantation in patients with type 1 diabetes: data from the Swiss-French GRAGIL Network. Am J Transplant 2021; 21: 3725– 3733 33961335
  6. [6]Wojtusciszyn A, Branchereau J, Esposito L,.; TREPID Group. Indications for islet or pancreatic transplantation: statement of the TREPID Working Group on behalf of the Société francophone du diabète (SFD), Société francaise d’endocrinologie (SFE), Société francophone de transplantation (SFT) and Société française de néphrologie-dialyse-transplantation (SFNDT). Diabetes Metab 2019; 45: 224– 237 30223084
  7. [8]Marfil-Garza BA, Imes S, Verhoeff K,. Pancreatic islet transplantation in type 1 diabetes: 20-year experience from a single-centre cohort in Canada. Lancet Diabetes Endocrinol 2022; 10: 519– 532 35588757
  8. [9]Lemos JRN, Baidal DA, Ricordi C, Fuenmayor V, Alvarez A, Alejandro R. Survival after islet transplantation in subjects with type 1 diabetes: twenty-year follow-up. Diabetes Care 2021; 44: e67– e68 33579716 PMC7985423
  9. [10]Markmann JF, Rickels MR, Eggerman TL,. Phase 3 trial of human islet-after-kidney transplantation in type 1 diabetes. Am J Transplant 2021; 21: 1477– 1492 32627352 PMC9074710
  10. [11]Rickels MR, Eggerman TL, Bayman L,.; Clinical Islet Transplantation Consortium. Long-term outcomes with islet-alone and islet-after-kidney transplantation for type 1 diabetes in the Clinical Islet Transplantation Consortium: the CIT-08 study. Diabetes Care 2022; 45: 2967– 2975 36250905 PMC9767903
  11. [12]Fiorina P, Gremizzi C, Maffi P,. Islet transplantation is associated with an improvement of cardiovascular function in type 1 diabetic kidney transplant patients. Diabetes Care 2005; 28: 1358– 1365 15920052
  12. [13]Fiorina P, Venturini M, Folli F,. Natural history of kidney graft survival, hypertrophy, and vascular function in end-stage renal disease type 1 diabetic kidney-transplanted patients: beneficial impact of pancreas and successful islet cotransplantation. Diabetes Care 2005; 28: 1303– 1310 15920043
  13. [15]von Elm E, Altman DG, Egger M,.; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 2007; 335: 806– 808 17947786 PMC2034723
  14. [16]Borot S, Niclauss N, Wojtusciszyn A,.; GRAGIL Network. Impact of the number of infusions on 2-year results of islet-after-kidney transplantation in the GRAGIL network. Transplantation 2011; 92: 1031– 1038 21926944
  15. [17]Badet L, Benhamou PY, Wojtusciszyn A,.; GRAGIL Group. Expectations and strategies regarding islet transplantation: metabolic data from the GRAGIL 2 trial. Transplantation 2007; 84: 89– 96 17627243
  16. [18]Lablanche S, Vantyghem M-C, Kessler L,.; TRIMECO trial investigators. Islet transplantation versus insulin therapy in patients with type 1 diabetes with severe hypoglycaemia or poorly controlled glycaemia after kidney transplantation (TRIMECO): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol 2018; 6: 527– 537 29776895
  17. [19]Semenzato L, Botton J, Drouin J,. Chronic diseases, health conditions and risk of COVID-19-related hospitalization and in-hospital mortality during the first wave of the epidemic in France: a cohort study of 66 million people. Lancet Reg Health Eur 2021; 8: 100158 34308411 PMC8282330
  18. [20]Hoisnard L, Pina Vegas L, Dray-Spira R, Weill A, Zureik M, Sbidian E. Risk of major adverse cardiovascular and venous thromboembolism events in patients with rheumatoid arthritis exposed to JAK inhibitors versus adalimumab: a nationwide cohort study. Ann Rheum Dis 2023; 82: 182– 188 36198438
  19. [21]Marcombes C, Penso L, Weill A, Dray-Spira R, Zureik M, Sbidian E. Persistence of second-line biologics in psoriasis after first-line biologic failure: a nationwide cohort study from the French health insurance database (SNDS). Br J Dermatol 2023; 189: 561– 568 37479503
  20. [22]Lip GYH, Keshishian A, Kamble S,. Real-world comparison of major bleeding risk among non-valvular atrial fibrillation patients initiated on apixaban, dabigatran, rivaroxaban, or warfarin. A propensity score matched analysis. Thromb Haemost 2016; 116: 975– 986 27538358
  21. [23]Nakamura T, Fujikura J, Anazawa T,. Long-term outcome of islet transplantation on insulin-dependent diabetes mellitus: an observational cohort study. J Diabetes Investig 2020; 11: 363– 372 PMC7078128 31390159
  22. [25]Carstensen B, Read SH, Friis S,.; Diabetes and Cancer Research Consortium. Cancer incidence in persons with type 1 diabetes: a five-country study of 9,000 cancers in type 1 diabetic individuals. Diabetologia 2016; 59: 980– 988 26924393 PMC4826427
  23. [26]Lablanche S, Borot S, Wojtusciszyn A,.; GRAGIL Network. Five-year metabolic, functional, and safety results of patients with type 1 diabetes transplanted with allogenic islets within the Swiss-French GRAGIL Network. Diabetes Care 2015; 38: 1714– 1722 26068866
  24. [27]Caiazzo R, Vantyghem M-C, Raverdi V,. Impact of procedure-related complications on long-term islet transplantation outcome. Transplantation 2015; 99: 979– 984 25393157
  25. [28]Peixoto E, Vendrame F, Arnau A,. Ten years of preserved kidney function after islet transplant graft failure. Diabetes Care 2016; 39: e209– e211 27650978 PMC5127237
  26. [29]Maanaoui M, Lenain R, Foucher Y,. Islet transplantation versus insulin alone in type 1 diabetic kidney transplant recipients: a French nationwide study on behalf of the TREPID group. Transplantation 2023; 107: 142– 142
  27. [30]Wong G, Hayen A, Chapman JR,. Association of CKD and cancer risk in older people. J Am Soc Nephrol 2009; 20: 1341– 1350 19406977 PMC2689896
  28. [31]Go AS, Chertow GM, Fan D, McCulloch CE, Hsu C-Y. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004; 351: 1296– 1305 15385656
  29. [32]Danielson KK, Hatipoglu B, Kinzer K,. Reduction in carotid intima-media thickness after pancreatic islet transplantation in patients with type 1 diabetes. Diabetes Care 2013; 36: 450– 456 23172970 PMC3554308
  30. [33]Madrigal JM, Monson RS, Hatipoglu B,. Coronary artery calcium may stabilize following islet cell transplantation in patients with type 1 diabetes. Clin Transplant 2017; 31: e13059 PMC5633499 28748581
  31. [34]Sagris M, Antonopoulos AS, Theofilis P,. Risk factors profile of young and older patients with myocardial infarction. Cardiovasc Res 2022; 118: 2281– 2292 34358302
  32. [35]Benhamou P-Y, Lablanche S, Vambergue A,. The beneficial effects of closed-loop insulin delivery in patients with highly unstable type 1 diabetes eligible for islet transplantation are maintained over 6 months: an extension study of the DBLHU-WP10 trial. Diabetes Obes Metab 2022; 24: 956– 961 35099098
  33. [36]Renard E, Joubert M, Villard O,.; iDCL Trial Research Group. Safety and efficacy of sustained automated insulin delivery compared with sensor and pump therapy in adults with Type 1 diabetes at high risk for hypoglycemia: a randomized controlled trial. Diabetes Care 2023; 46: 2180– 2187 37729080 PMC10698222
  34. [37]Lablanche S, David-Tchouda S, Margier J,. Randomised, prospective, medico-economic nationwide French study of islet transplantation in patients with severely unstable type 1 diabetes: the STABILOT study protocol. BMJ Open 2017; 7: e013434 PMC5337667 28219959
  35. [38]Hussain S, Braune K, Forbes S, Senior PA. Closed-loop systems: a bridge to cell therapy for type 1 diabetes? Lancet Diabetes Endocrinol 2024; 12: 782– 784 39178874
  36. [39]Thorlund K, Dron L, Park JJH, Mills EJ. Synthetic and external controls in clinical trials - a primer for researchers. Clin Epidemiol 2020; 12: 457– 467 32440224 PMC7218288

Authors
Perrier, Q., Jambon-Barbara, C., Kessler, L., Villard, O., Buron, F., Guerci, B., Borot, S., Roustit, M., Berishvilli, E., Rakotoarisoa, L., Vantyghem, M.-C., Morelon, E., Renard, E., Besch, C., Berney, T., Benhamou, P.-Y., Lablanche, S., GRAGIL Network, Janbon, B., Noble, J., Jouve, T., Malvezzi, P., Sabatier, J., Broca, C., Granziera, S., Heim, M., Greget, M., Besch, C., Faitot, F., Morelon, A., Thaunat, O., Badet, L., Thivolet, C., Berney, T., Widmer, C., Peloso, A., Wassmer, C.-H., Berishvili, Lebreton, F., Parnaud, G., Pernin, N., Bosco, D., Tauveron, I., Esposito, L., Melki, V., Cattan, P., Peraldi, M. N., Armanet, M., Durrbach, A., Frimat, L., & Guerci, B.
Affiliations
  • Inserm (FR)
  • Centre National de la Recherche Scientifique (FR)
  • Hospices Civils de Lyon (FR)
  • Centre Hospitalier Universitaire de Besançon (FR)
  • University of Geneva (CH)
  • 5University of Lyon, Department of Nephrology, Immunology and Transplantation, Hospices Civils de Lyon, Lyon, France
  • 4University of Montpellier, INSERM U1191, CNRS UMR5203, Department of Endocrinology and Diabetes, University Hospital of Montpellier, Montpellier, France
Corresponding author
Perrier, Quentin
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2025-04-17
Volume
48
Issue
6
Pages
1007-1015
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc25-0059
PMC
PMC12094206
OpenAlex
W4409591883
Cited by
15
References
39
Citations by year
2026: 9 · 2025: 6
FWCI
14.03
Type
journal article
Language
en
Open access
Licence
www.diabetesjournals.org/journals/pages/license (vor)
Locations
  • Diabetes Care (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Funders
  • Agence de la Biomédecine
  • Grenoble Alpes University Hospital
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, diabetes complications, mortality, kidney transplantation, dialysis, cancer risk, immunosuppressants, stroke, myocardial infarction, amputation, risk-benefit assessment
MeSH terms
Adult, Diabetes Mellitus, Type 1, Female, Humans, Male, Middle Aged, Retrospective Studies, Kidney Transplantation, Islets of Langerhans Transplantation, Diabetes Complications

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