Study examines 10-year outcomes of islet transplantation
Islet transplantation with the Edmonton protocol can provide 10-year markedly improved metabolic control without severe hypoglycaemia in three-quarters of people with type 1 diabetes with or without kidney transplants, a French study has concluded.
Researchers from Lille’s Hôpital Claude Huriez set out to evaluate the long-term outcome of islet transplantation in people with type 1 diabetes and hypoglyceamia unawareness and, or, a functioning kidney graft, with the results published in Diabetes Care.
Thank hey studied 28 participants with the condition who received islet transplantation either alone (ITA) or after a kidney graft (IAK). 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.
The Edmonton Protocol is a method of implantation of pancreatic islets, involving isolating islets from a cadaveric donor pancreas using a mixture of enzymes called Liberase (Roche).
Summarising the results, the researchers said: “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 five 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 one month after the last islet infusion, was significantly associated with the duration of graft function and insulin independence.”
The researchers concluded: “Islet transplantation with the Edmonton protocol can provide 10-year markedly improved metabolic control without SHEs in three-quarters of patients with type 1 diabetes, kidney transplanted or not.”
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