Ten-Year Outcome of Islet Alone or Islet After Kidney Transplantation in Type 1 Diabetes: A Prospective Parallel-Arm Cohort Study

Vantyghem, Marie-Christine; Chetboun, Mikael; Gmyr, Valéry; Jannin, Arnaud; Espiard, Stéphanie; Le Mapihan, Kristell; Raverdy, Violeta; Delalleau, Nathalie; Machuron, François; Hubert, Thomas; Frimat, Marie; van Belle, Eric; Hazzan, Marc; Pigny, Pascal; Noel, Christian; Caiazzo, Robert; Kerr-Conte, Julie; Pattou, François; Choukroun, Gabriel

Document type :

Article dans une revue scientifique: Article original

DOI :

Title :

Ten-Year Outcome of Islet Alone or Islet After Kidney Transplantation in Type 1 Diabetes: A Prospective Parallel-Arm Cohort Study

Author(s) :

Vantyghem, Marie-Christine [Auteur]

Recherche translationnelle sur le diabète - U 1190 [RTD]
Chetboun, Mikael [Auteur]

Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 [EGID]
Recherche translationnelle sur le diabète - U 1190 [RTD]
Gmyr, Valéry [Auteur]
Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 [EGID]
Recherche translationnelle sur le diabète - U 1190 [RTD]
Jannin, Arnaud [Auteur]
Service Endocrinologie, diabétologie, maladies métaboliques et nutrition [LILLE - Endocrino]
Espiard, Stéphanie [Auteur]
Service Endocrinologie, diabétologie, maladies métaboliques et nutrition [LILLE - Endocrino]
Le Mapihan, Kristell [Auteur]
Raverdy, Violeta [Auteur]

Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 [EGID]
Recherche translationnelle sur le diabète - U 1190 [RTD]
Delalleau, Nathalie [Auteur]

Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 [EGID]
Recherche translationnelle sur le diabète - U 1190 [RTD]
Machuron, François [Auteur]
Hubert, Thomas [Auteur]

Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 [EGID]
Recherche translationnelle sur le diabète - U 1190 [RTD]
Frimat, Marie [Auteur]

Lille Inflammation Research International Center - U 995 [LIRIC]
van Belle, Eric [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Hazzan, Marc [Auteur]

Pigny, Pascal [Auteur]

Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Noel, Christian [Auteur]
Caiazzo, Robert [Auteur]

Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 [EGID]
Recherche translationnelle sur le diabète - U 1190 [RTD]
Kerr-Conte, Julie [Auteur]
Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 [EGID]
Recherche translationnelle sur le diabète - U 1190 [RTD]
Pattou, François [Auteur]
Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 [EGID]
Recherche translationnelle sur le diabète - U 1190 [RTD]
Choukroun, Gabriel [Collaborateur]
Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]

Journal title :

Diabetes Care

Pages :

2042-2049

Publisher :

American Diabetes Association

Publication date :

2019-11-01

ISSN :

0149-5992

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

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 ...
Show more >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 function and insulin independence. CONCLUSIONS 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.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

ANR Project :

EGID Diabetes Pole

Collections :