Transplant International (Dec 2023)

Primary Graft Function and 5 Year Insulin Independence After Pancreas and Islet Transplantation for Type 1 Diabetes: A Retrospective Parallel Cohort Study

  • Mikael Chetboun,
  • Mikael Chetboun,
  • Mikael Chetboun,
  • Mikael Chetboun,
  • Christophe Masset,
  • Christophe Masset,
  • Mehdi Maanaoui,
  • Mehdi Maanaoui,
  • Mehdi Maanaoui,
  • Mehdi Maanaoui,
  • Frédérique Defrance,
  • Valéry Gmyr,
  • Valéry Gmyr,
  • Valéry Gmyr,
  • Violeta Raverdy,
  • Violeta Raverdy,
  • Violeta Raverdy,
  • Violeta Raverdy,
  • Thomas Hubert,
  • Thomas Hubert,
  • Thomas Hubert,
  • Caroline Bonner,
  • Caroline Bonner,
  • Caroline Bonner,
  • Lisa Supiot,
  • Clarisse Kerleau,
  • Gilles Blancho,
  • Gilles Blancho,
  • Julien Branchereau,
  • Julien Branchereau,
  • Georges Karam,
  • Georges Karam,
  • Ismaël Chelghaf,
  • Aurélie Houzet,
  • Magali Giral,
  • Magali Giral,
  • Claire Garandeau,
  • Jacques Dantal,
  • Jacques Dantal,
  • Kristell Le Mapihan,
  • Arnaud Jannin,
  • Marc Hazzan,
  • Robert Caiazzo,
  • Robert Caiazzo,
  • Robert Caiazzo,
  • Robert Caiazzo,
  • Julie Kerr-Conte,
  • Julie Kerr-Conte,
  • Julie Kerr-Conte,
  • Marie-Christine Vantyghem,
  • Marie-Christine Vantyghem,
  • Marie-Christine Vantyghem,
  • Marie-Christine Vantyghem,
  • Diego Cantarovich,
  • François Pattou,
  • François Pattou,
  • François Pattou,
  • François Pattou

DOI
https://doi.org/10.3389/ti.2023.11950
Journal volume & issue
Vol. 36

Abstract

Read online

In islet transplantation (ITx), primary graft function (PGF) or beta cell function measured early after last infusion is closely associated with long term clinical outcomes. We investigated the association between PGF and 5 year insulin independence rate in ITx and pancreas transplantation (PTx) recipients. This retrospective multicenter study included type 1 diabetes patients who underwent ITx in Lille and PTx in Nantes from 2000 to 2022. PGF was assessed using the validated Beta2-score and compared to normoglycemic control subjects. Subsequently, the 5 year insulin independence rates, as predicted by a validated PGF-based model, were compared to the actual rates observed in ITx and PTx patients. The study enrolled 39 ITx (23 ITA, 16 IAK), 209 PTx recipients (23 PTA, 14 PAK, 172 SPK), and 56 normoglycemic controls. Mean[SD] PGF was lower after ITx (ITA 22.3[5.2], IAK 24.8[6.4], than after PTx (PTA 38.9[15.3], PAK 36.8[9.0], SPK 38.7[10.5]), and lower than mean beta-cell function measured in normoglycemic control: 36.6[4.3]. The insulin independence rates observed at 5 years after PTA and PAK aligned with PGF predictions, and was higher after SPK. Our results indicate a similar relation between PGF and 5 year insulin independence in ITx and solitary PTx, shedding new light on long-term transplantation outcomes.

Keywords