Impact of Procedure-Related Complications on Long-term Islet Transplantation Outcome

被引:13
作者
Caiazzo, Robert [1 ,2 ]
Vantyghem, Marie-Christine [1 ,3 ]
Raverdi, Violeta [1 ,2 ]
Bonner, Caroline [1 ,4 ]
Gmyr, Valery [1 ,4 ]
Defrance, Frederique [3 ]
Leroy, Clara [3 ]
Sergent, Geraldine [5 ]
Hubert, Thomas [1 ,4 ]
Ernst, Oliver [5 ]
Noel, Christian [6 ]
Kerr-Conte, Julie [1 ,4 ]
Pattou, Francois [1 ,2 ]
机构
[1] French Natl Inst Hlth & Med Res INSERM UMR 859, Diabet Cell Therapy Lille, Lille, France
[2] Univ Lille Nord France, Gen & Endocrine Surg Dept, Lille Univ Hosp, Lille, France
[3] Univ Lille Nord France, Dept Endocrinol & Metab, Lille Univ Hosp, Lille, France
[4] Univ Lille, Lille, France
[5] Univ Lille Nord France, Lille Univ Hosp, Dept Radiol, Lille, France
[6] Univ Lille Nord France, Lille Univ Hosp, Dept Nephrol, Lille, France
关键词
PRIMARY GRAFT FUNCTION; INSULIN-INDEPENDENCE; CELL TRANSPLANTATION; INFUSION; LIVER;
D O I
10.1097/TP.0000000000000458
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Pancreatic islet transplantation offers a promising biotherapy for the treatment of type 1 diabetes, but this procedure hasmet significant challenges over the years. One such challenge is to address why primary graft function still remains inconsistent after islet transplantation. Several variables have been shown to affect graft function, but the impact of procedure-related complications on primary and long-term graft functions has not yet been explored. Methods. Twenty-six patients with established type 1 diabetes were included in this study. Each patient had two to three intraportal islet infusions to obtain 10,000 islet equivalent (IEQ)/kg in body weight, equaling a total of 68 islet infusions. Islet transplantation consisted of three sequential fresh islet infusions within 3 months. Islet infusions were performed surgically or under ultrasound guidance, depending on patient morphology, availability of the radiology suite, and patient medical history. Prospective assessment of adverse events was recorded and graded using "Common Terminology Criteria for adverse events in Trials of Adult Pancreatic Islet Transplantation." Results. There were no deaths or patients dropouts. Early complications occurred in nine of 68 procedures. beta score 1 month after the last graft and optimal graft function (beta score >= 7) rate were significantly lower in cases of procedure-related complications (P = 0.02, P = 0.03). Procedure-related complications negatively impacted graft function (P = 0.009) and was an independent predictive factor of long-term graft survival (P = 0.033) in multivariate analysis. Conclusion. Complications occurring during radiologic or surgical intraportal islet transplantation significantly impair primary graft function and graft survival regardless of their severity.
引用
收藏
页码:979 / 984
页数:6
相关论文
共 33 条
[1]  
[Anonymous], 7 CITR
[2]   The bag method for islet cell infusion [J].
Baidal, DA ;
Froud, T ;
Ferreira, JV ;
Khan, A ;
Alejandro, R ;
Ricordi, C .
CELL TRANSPLANTATION, 2003, 12 (07) :809-813
[3]   Improvement in Outcomes of Clinical Islet Transplantation: 1999-2010 [J].
Barton, Franca B. ;
Rickels, Michael R. ;
Alejandro, Rodolfo ;
Hering, Bernhard J. ;
Wease, Stephen ;
Naziruddin, Bashoo ;
Oberholzer, Jose ;
Odorico, Jon S. ;
Garfinkel, Marc R. ;
Levy, Marlon ;
Pattou, Francois ;
Berney, Thierry ;
Secchi, Antonio ;
Messinger, Shari ;
Senior, Peter A. ;
Maffi, Paola ;
Posselt, Andrew ;
Stock, Peter G. ;
Kaufman, Dixon B. ;
Luo, Xunrong ;
Kandeel, Fouad ;
Cagliero, Enrico ;
Turgeon, Nicole A. ;
Witkowski, Piotr ;
Naji, Ali ;
O'Connell, Philip J. ;
Greenbaum, Carla ;
Kudva, Yogish C. ;
Brayman, Kenneth L. ;
Aull, Meredith J. ;
Larsen, Christian ;
Kay, Tom W. H. ;
Fernandez, Luis A. ;
Vantyghem, Marie-Christine ;
Bellin, Melena ;
Shapiro, A. M. James .
DIABETES CARE, 2012, 35 (07) :1436-1445
[4]   Long-Term Insulin-Independence After Allogeneic Islet Transplantation for Type 1 Diabetes: Over the 10-Year Mark [J].
Berney, T. ;
Ferrari-Lacraz, S. ;
Buehler, L. ;
Oberholzer, J. ;
Marangon, N. ;
Philippe, J. ;
Villard, J. ;
Morel, P. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2009, 9 (02) :419-423
[5]   Quantitative in vivo islet potency assay in normoglycemic nude mice correlates with primary graft function after clinical transplantation [J].
Caiazzo, Robert ;
Gmyr, Valery ;
Kremer, Bertrand ;
Hubert, Thomas ;
Soudan, Benoit ;
Lukowiak, Bruno ;
Vandewalle, Brigitte ;
Vantyghem, Marie-Christine ;
Pattou, Francois ;
Kerr-Conte, Julie .
TRANSPLANTATION, 2008, 86 (02) :360-363
[6]   Influence of microenvironment on engraftment of transplanted ββ-cells [J].
Carlsson, Per-Ola .
UPSALA JOURNAL OF MEDICAL SCIENCES, 2011, 116 (01) :1-7
[7]  
CIT, 2007, TERM CRIT ADV EV TCA
[8]   Feasibility and safety of pancreatic islet transplantation in the liver by portal vein catheterization using the transjugular route [J].
Conget, I ;
Piquer, S ;
Julià, M ;
Gomis, R ;
Esmatjes, E ;
García-Pagán, JC ;
Bosch, J ;
Gilabert, R ;
Ricart, MJ ;
Fernández-Cruz, L ;
Manyalich, M .
TRANSPLANTATION, 2006, 81 (08) :1220-1221
[9]   The role of interventional radiology and imaging in pancreatic islet cell transplantation [J].
Dixon, S. ;
Tapping, C. R. ;
Walker, J. N. ;
Bratby, M. ;
Anthony, S. ;
Boardman, P. ;
Phillips-Hughes, J. ;
Uberoi, R. .
CLINICAL RADIOLOGY, 2012, 67 (09) :923-931
[10]   Transplanted Functional Islet Mass: Donor, Islet Preparation, and Recipient Factors Influence Early Graft Function in Islet-After-Kidney Patients [J].
Friberg, Andrew S. ;
Lundgren, Torbjorn ;
Malm, Helene ;
Felldin, Marie ;
Nilsson, Bo ;
Jenssen, Trond ;
Kyllonen, Lauri ;
Tufveson, Gunnar ;
Tibell, Annika ;
Korsgren, Olle .
TRANSPLANTATION, 2012, 93 (06) :632-638