PATIENTS with Type 1 diabetes who have received a kidney transplant may experience a reduced transplant failure risk, as well as a boost in life expectancy, following pancreatic islet transplantation, versus insulin alone.
New data presented at the European Society for Organ Transplantation (ESOT) Congress compared patients diagnosed with Type 1 diabetes who had received transplants of both kidney and pancreatic islets, with those who had received a kidney transplant, but who managed their diabetes with insulin alone. The cohort from a French nationwide study included 2,393 patients with Type 1 diabetes, all of whom were given a kidney transplant between 2000–2017. Across the trial period, 381 patients were eligible for pancreatic islet transplantation, and 47 of these underwent the procedure. Patients were matched using the following controls: age, kidney function, and glycated haemoglobin test levels. The main outcome reached was graft failure, which was defined by return to dialysis, or death.
According to data, the median time for pancreatic islet transplantation to take place was 34.8 months, with a hazard ratio for graft failure in this patient population of 0.47; this indicates a finding of a 53% lower risk for transplant failure when compared with the insulin-only group. Researchers also found that patients who were recipients of a pancreatic islet transplantation had a higher life expectancy at the 10-year follow-up point (9.61 years compared with 8.85 years for patients on insulin). At the 1-year follow-up after pancreatic islet transplantation had taken place, researchers found an 89.4% probability of graft survival, due to the 70.2% probability for patients to achieve independence from using insulin.
Lead researcher Mehdi Maanaoui, Centre Hospitalier Régional Universitaire de Lille, France, commented: “Although islet transplantation has previously been shown to improve glycaemic control compared with conventional insulin therapy, little was known about its long-term impact until now.” Maanaoui stressed: “These results are exciting, and provide hope for people with Type 1 diabetes and kidney transplants.”
Overall, the researchers promoted the importance of using pancreatic islet transplantation in this patient population. Further research is needed in this arena, but it is hoped that these findings will increase the access of patients in receiving pancreatic islet transplantation.
