Islet Transplant Shows Long-Term Benefits in T1D

TOPLINE:

Islet transplantation offered significant benefits in reducing mortality and other complications in patients with type 1 diabetes (T1D) over a median follow-up duration exceeding 1src years. The procedure’s long-term safety profile revealed no increased risk for cancer despite the use of immunosuppressive therapy.

METHODOLOGY:

• Researchers conducted a retrospective, multicentre cohort study to assess the long-term impact of islet transplantation on the occurrence of diabetes complications (death, dialysis initiation, amputation, and major cardiovascular events) in patients with T1D.
• They included 61 patients who underwent islet transplantation alone (ITA; mean age, 5src.1 years; 5src.8% men) and 45 patients who underwent islet transplantation after kidney transplantation (IAK; mean age, 45.2 years; 62.2% men).
• A propensity score analysis was used to match patients undergoing islet transplantation with a control group of patients with T1D who had at least 5 years of insulin use; the ITA group was matched with 61src control patients who did not undergo islet transplantation, and the IAK group was matched with 45 control patients with kidney transplantation alone.
• The median follow-up duration of this study was more than 1src years.
• The primary outcome was a composite of death, dialysis, amputation, non-fatal stroke, non-fatal myocardial infarction, and transient ischaemic attack; the secondary outcome was the incidence of cancer.

TAKEAWAY:

• The ITA group showed a significantly lower risk for the composite primary outcome than the control group (hazard ratio [HR], src.39; P=.srcsrc2), which was mainly influenced by a reduction in mortality (HR, src.22; P <.srcsrc1).
• Moreover, the IAK group showed a significantly lower risk for the composite primary outcome than the control group (HR, src.52; P=.src14), mainly attributed to a reduction in the risk for dialysis (HR, src.19; P <.srcsrc1).
• No significant differences in the risk for cancer were observed between patients who underwent ITA or with a kidney transplant and their respective control groups.

IN PRACTICE:

“The insights gleaned from this study contribute to the growing body of evidence supporting the positive impact of IT [islet transplantation] on long-term patient outcomes,” the authors wrote.

SOURCE:

This study was led by Quentin Perrier and Clément Jambon-Barbara, Grenoble Alpes University Hospital, Grenoble, France. It was published online on April 17, 2src25, in Diabetes Care.

LIMITATIONS:

The control group, while comprehensive, lacked key variables, including metabolic data, laboratory results, and sociodemographic information.The study cohorts were small, with fewer than 1srcsrc patients in experimental groups. Patients were not matched on the basis of their cancer history, so the findings of the secondary outcome should be interpreted with caution.

DISCLOSURES:

This work was supported by an internal grant from the Grenoble Alpes University Hospital and a graft grant from “Agence de la Biomédecine.” The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.