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Multicenter Study
. 2025 Jun 1;48(6):1007-1015.
doi: 10.2337/dc25-0059.

Impact of Islet Transplantation on Diabetes Complications and Mortality in Patients Living With Type 1 Diabetes

Quentin Perrier  1 , Clément Jambon-Barbara  2 , Laurence Kessler  3 , Orianne Villard  4 , Fanny Buron  5 , Bruno Guerci  6 , Sophie Borot  7 , Matthieu Roustit  8 , Ekaterine Berishvilli  9 , Luc Rakotoarisoa  3 , Marie-Christine Vantyghem  10 , Emmanuel Morelon  5 , Eric Renard  4 , Camille Besch  3 , Thierry Berney  5   9 , Pierre-Yves Benhamou  11 , Sandrine Lablanche  11 ; GRAGIL Network
Collaborators, Affiliations
Multicenter Study

Impact of Islet Transplantation on Diabetes Complications and Mortality in Patients Living With Type 1 Diabetes

Quentin Perrier et al. Diabetes Care. .

Abstract

Objective: This study aimed to evaluate the impact of islet transplantation (IT) on diabetes complications, death, and cancer incidence.

Research design and methods: This retrospective, multicenter, cohort study included patients from three IT clinical trials (intervention group) and from the French health insurance claims database Système National des Données de Santé (SNDS) (control group). Two cohorts of IT recipients were analyzed: IT recipients after kidney transplantation (IAK) and IT recipients alone (ITA). They were matched with patients living with type 1 diabetes (T1D) from the SNDS using a propensity score. The primary outcome was a composite criterion including death, dialysis, amputation, nonfatal stroke, nonfatal myocardial infarction, and transient ischemic attack. The secondary outcome was cancer. Hazard ratio (HRs) and P values were obtained using Cox proportional hazards analysis and log-rank test, respectively.

Results: The study included 61 ITA recipients matched to 610 T1D control patients and 45 IAK recipients matched to 45 T1D control patients over a median follow-up period >10 years. Compared with T1D control patients, ITA and IAK recipients had a lower composite outcome risk (HR 0.39 [95% CI 0.21-0.71; P = 0.002] and 0.52 [0.30-0.88; P = 0.014], respectively) that seemed driven by reduced mortality (0.22 [0.09-0.54]; P < 0.001) for ITA and reduced dialysis (0.19 [0.07-0.50]; P < 0.001) for IAK. Both groups showed no significant changes in cancer risk.

Conclusions: This study suggests long-term benefits of IT on diabetes-related outcomes. Furthermore, despite the use of immunosuppressive drugs following IT, we observed no significant increase in the risk of cancer. Altogether, these findings highlight a favorable risk-benefit ratio of IT in treating patients with unstable T1D.

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Conflict of interest statement

Duality of Interest. No potential conflicts of interest relevant to the article were reported.

Figures

None
Graphical abstract
Figure 1
Figure 1
Kaplan-Meier survival curves of the primary composite outcome in the ITA (A) and IAK (B) groups. Time is given in years.
Figure 2
Figure 2
Kaplan-Meier survival curves of the secondary cancer (A) and death (B) outcomes in the ITA group and the secondary cancer (C) and dialysis (D) outcomes in the IAK group. Time is given in years.
See this image and copyright information in PMC

References

    1. Pease A, Lo C, Earnest A, Kiriakova V, Liew D, Zoungas S.. The efficacy of technology in type 1 diabetes: a systematic review, network meta-analysis, and narrative synthesis. Diabetes Technol Ther 2020;22:411–421 - PubMed
    1. Nathan DM; DCCT/EDIC Research Group . The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study at 30 years: overview. Diabetes Care 2014;37:9–16 - PMC - PubMed
    1. Brennan DC, Kopetskie HA, Sayre PH, et al. . Long-term follow-up of the Edmonton protocol of islet transplantation in the United States. Am J Transplant 2016;16:509–517 - PubMed
    1. Vantyghem M-C, Chetboun M, Gmyr V, et al. . Erratum. Ten-year outcome of islet alone or islet after kidney transplantation in type 1 diabetes: a prospective parallel-arm cohort study. Diabetes Care 2019;42:2042-2049. Diabetes Care 2020;43:1164–2049 - PubMed
    1. Lablanche S, Borot S, Wojtusciszyn A, et al. .; GRAGIL Network . Ten-year outcomes of islet transplantation in patients with type 1 diabetes: data from the Swiss-French GRAGIL Network. Am J Transplant 2021;21:3725–3733 - PubMed

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