Ten-year outcomes of islet transplantation in patients with type 1 diabetes: Data from the Swiss-French GRAGIL network

被引：30

作者：

Lablanche, Sandrine ^{[1
,2
,3
]}

Borot, Sophie ^{[4
]}

Wojtusciszyn, Anne ^{[5
,6
]}

Skaare, Kristina ^{[7
,8
]}

Penfornis, Alfred ^{[9
]}

Malvezzi, Paolo ^{[10
]}

Badet, Lionel ^{[11
]}

Thivolet, Charles ^{[12
]}

Morelon, Emmanuel ^{[13
]}

Buron, Fanny ^{[13
]}

Renard, Eric ^{[5
,6
]}

Tauveron, Igor ^{[14
,15
]}

Villard, Oriane ^{[5
,6
]}

Munch, Marion ^{[19
,20
]}

Sommacal, Salome ^{[2
]}

Clouaire, Lea ^{[2
]}

Jacquet, Morgane ^{[2
]}

Gonsaud, Laura ^{[2
]}

Camillo-Brault, Coralie ^{[16
]}

Colin, Cyrille ^{[16
]}

Bosson, Jean-Luc ^{[7
,8
]}

Bosco, Domenico ^{[17
,18
]}

Berney, Thierry ^{[17
,18
]}

Kessler, Laurence ^{[19
,20
]}

Benhamou, Pierre-Yves ^{[1
,2
,3
]}

机构：

[1] Univ Grenoble Alpes, LBFA, Grenoble, France

[2] Grenoble Univ Hosp, Dept Endocrinol, Pole DigiDune, Grenoble Alpes, Grenoble, France

[3] INSERM, Grenoble, France

[4] CHU Jean Minjoz, Serv Endocrinol Metab & Diabetol Nutr, Besancon, France

[5] Ctr Hosp Montpellier, Pole Rein Hypertens Metab, Serv Endocrinol Montpellier France, Serv Endocrinol Diabete & Metab, Lausanne, Switzerland

[6] Ctr Hosp Montpellier, Dept Med, Lausanne, Switzerland

[7] Univ Grenoble Alpes, Grenoble Univ Hosp, CNRS, Dept Publ Hlth, Grenoble, France

[8] TIMC IMAG, Grenoble, France

[9] Ctr Hosp Sud Francilien, Serv Endocrinol Diabetol & Malad Metabol, Corbeil Essonnes, France

[10] CHU Grenoble Alpes, Serv Nephrol Dialyse Aphereses & Transplantat, Grenoble, France

[11] Hosp Civils Lyon, Serv Urol & Chirurg Transplantat, Pole Chirurg, Lyon, France

[12] Hosp Civils Lyon, Serv Endocrinol Diabete Nutr, Lyon, France

[13] Hosp Civils Lyon, Serv Transplantat Nephrol & Immunol Clin, Lyon, France

[14] Univ Clermont Auvergne, CHU Clermont Ferrand, Serv Endocrinol Diabete Malad Metab, Clermont Ferrand, France

[15] Univ Clermont Auvergne, CNR56293, INSERM, GreD,UMR 1103, Clermont Ferrand, France

[16] Hosp Civils Lyon, Serv Evaluat Econ Sante, Pole Sante Publ, Lyon, France

[17] Univ Geneva, Islet Isolat & Transplantat Ctr, Dept Surg, Geneva, Switzerland

[18] Univ Geneva, Geneva Univ Hosp, Geneva, Switzerland

[19] Univ Strasbourg, Hop Univ Strasbourg, Serv Endocrinol Diabete & Nutr, Pole MIRNED, Strasbourg, France

[20] Univ Strasbourg, Nanomed Regenerat, INSERM, UMR 1260, Strasbourg, France

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2021年 / 21卷 / 11期

关键词：

clinical research; practice; diabetes; type; 1; endocrinology; diabetology; islets of Langerhans; INSULIN-INDEPENDENCE; EDMONTON PROTOCOL; GRAFT FUNCTION; BETA-SCORE; FOLLOW-UP; TRIAL; IMPROVEMENT; SECRETION; THERAPY; PHASE-3;

D O I：

10.1111/ajt.16637

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

To describe the 10-year outcomes of islet transplantation within the Swiss-French GRAGIL Network, in patients with type 1 diabetes experiencing high glucose variability associated with severe hypoglycemia and/or with functional kidney graft. We conducted a retrospective analysis of all subjects transplanted in the GRAGIL-1c and GARGIL-2 islet transplantation trials and analyzed components of metabolic control, graft function and safety outcomes over the 10-year period of follow-up. Forty-four patients were included between September 2003 and April 2010. Thirty-one patients completed a 10-year follow-up. Ten years after islet transplantation, median HbA1c was 7.2% (6.2-8.0) (55 mmol/mol [44-64]) versus 8.0% (7.1-9.1) (64 mmol/mol [54-76]) before transplantation (p < .001). Seventeen of 23 (73.9%) recipients were free of severe hypoglycemia, 1/21 patients (4.8%) was insulin-independent and median C-peptide was 0.6 ng/ml (0.2-1.2). Insulin requirements (UI/kg/day) were 0.3 (0.1-0.5) versus 0.5 (0.4-0.6) before transplantation (p < .001). Median (IQR) beta-score was 1 (0-4) (p < .05 when comparing with pre-transplantation values) and 51.9% recipients had a functional islet graft at 10 years. With a 10-year follow-up in a multicentric network, islet transplantation provided sustained improvement of glycemic control and was efficient to prevent severe hypoglycemia in almost 75% of the recipients.

引用

页码：3725 / 3733

页数：9

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