Islet transplantation may reduce failure risk, boost life expectancy in patients with type 1 diabetes
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Key takeaways:
- Median time for islet transplantation was 34.8 months.
- The HR for graft failure in patients who had an islet transplantation was 0.47.
Pancreatic islet transplantation may reduce transplant failure risk and boost long-term survival vs. insulin alone in kidney transplant recipients with type 1 diabetes, new data show.
“Although islet transplantation has previously been shown to improve glycemic control compared with conventional insulin therapy, little was known about its long-term impact until now,” lead researcher Mehdi Maanaoui, MD, a nephrologist at the Centre Hospitalier Régional Universitaire de Lille, in France, said in a press release. “These results are exciting and provide hope for people with type 1 diabetes and kidney transplants.”
The research was presented at the European Society for Organ Transplantation Congress and compared patients with type 1 diabetes who received kidney and islet transplants to those who had kidney transplants and managed diabetes with insulin alone.
Investigators examined 2,393 patients with type 1 diabetes who were transplanted with a kidney from 2000 to 2017 in French nationwide study. During the trial period, 381 patients were eligible for islet transplantation.. Overall, 47 patients underwent islet transplantation.
Patients with islets were compared to controls treated with insulin only. Researchers matched the groups based on recipients’ age, kidney function or HbA1c levels for comparability. The main outcome was graft failure, defined by death or return to dialysis.
The median time for islet transplantation was 34.8 months, according to the results. The HR for graft failure in the islet group was 0.47, indicating a 53% lower risk for failure compared with the insulin-only group. Additionally, patients who received an islet transplant had a higher life expectancy at 10-year follow-up (9.61 years compared with 8.85 years for those on insulin). At 1 year following islet transplant, there was an estimated 89.4% probability of graft survival, the findings showed, as patients had a 70.2% probability of achieving independence from insulin.
“We observe a significant benefit of islet transplantation on the risk of graft failure and death in type 1 diabetic kidney transplant recipients,” the researchers wrote in the study. “These results provide incentives to promote islet transplantation in this population.”
While further research is required to “ensure the outcomes of islet transplantation begin to match the long-term success achieved with pancreas transplantation,” Maanaoui said in the release, “we hope these findings help to increase patient access to islet transplantation.”
References:
Islet transplantation boosts long-term survival in kidney transplant recipients with type 1 diabetes. https://www.eurekalert.org/news-releases/1001134. Published Sept. 17, 2023. Accessed Sept. 17, 2023.
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Maanaoui M, et al. Nephrol Dial Transplant. 2023;doi.org/10.1093/ndt/gfad063c_5876
Maanaoui M, et al. Islet transplantation versus insulin alone in type 1 diabetic kidney transplant recipients: A French nationwide study on behalf of the TREPID Group. Presented at: European Society for Organ Transplantation Congress; Sept. 17,2023; Athens.
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