Impact of the number of infusions on 2-year results of islet-after-kidney transplantation in the GRAGIL network

Details

Serval ID
serval:BIB_8D93A2CC6AE6
Type
Article: article from journal or magazin.
Collection
Publications
Title
Impact of the number of infusions on 2-year results of islet-after-kidney transplantation in the GRAGIL network
Journal
Transplantation
Author(s)
Borot S., Niclauss N., Wojtusciszyn A., Brault C., Demuylder-Mischler S., Muller Y., Giovannoni L., Parnaud G., Meier R., Badet L., Bayle F., Frimat L., Kessler L., Morelon E., Penfornis A., Thivolet C., Toso C., Morel P., Bosco D., Colin C., Benhamou P. Y., Berney T., Gragil Network
ISSN
1534-6080 (Electronic)
ISSN-L
0041-1337
Publication state
Published
Issued date
2011
Volume
92
Number
9
Pages
1031-8
Language
english
Notes
Borot, Sophie
Niclauss, Nadja
Wojtusciszyn, Anne
Brault, Coralie
Demuylder-Mischler, Sandrine
Muller, Yannick
Giovannoni, Laurianne
Parnaud, Geraldine
Meier, Raphael
Badet, Lionel
Bayle, Francois
Frimat, Luc
Kessler, Laurence
Morelon, Emmanuel
Penfornis, Alfred
Thivolet, Charles
Toso, Christian
Morel, Philippe
Bosco, Domenico
Colin, Cyrille
Benhamou, Pierre-Yves
Berney, Thierry
eng
Research Support, Non-U.S. Gov't
Transplantation. 2011 Nov 15;92(9):1031-8. doi: 10.1097/TP.0b013e318230c236.
Abstract
BACKGROUND: Insulin independence after islet transplantation is generally achieved after multiple infusions. However, single infusion would increase the number of recipients. Our aim was to evaluate the results of islet-after-kidney transplantation according to the number of infusions. METHODS: Islets were isolated at the Geneva University, shipped, and transplanted into French patients from the Swiss-French GRAGIL network, on the "Edmonton" immunosuppression protocol between 2004 and 2010. RESULTS: Nineteen patients were transplanted with 33 preparations. Fifteen patients reached 24 months follow-up; eight subjects were single-graft recipients and seven were double-graft recipients. Finally, single-graft recipients received a median of 5312 islet equivalents/kg (5186-6388) vs. 10,564 (10,054-11,375) for double-graft recipients (P=0.0003) with similar islet mass at first infusion. Insulin independence was achieved in five of eight single-graft subjects (62.5%) versus five of seven in double-graft subjects (71.4%), not significant. Median insulin independence duration was 4.7 (3.1-15.2) months after one infusion vs. 19 (9.6-20.8) months after two infusions (not significant). At 24 months posttransplant, comparing single- with double-graft patients, insulin doses were 0.23 (0.11-0.34) U/kg vs. 0.02 (0.0-0.23) U/kg, P=0.11; HbA1c was 6.5% (5.9%-6.8%) vs. 6.2% (5.9%-6.3%), P=0.16; and basal C-peptide was 302 (143-480) pmol/L vs. 599 (393-806) pmol/L, P=0.05. Only 37.5% of single-graft patients had a beta-score >/=4 compared with 100% of double-graft patients (P=0.03). Two recipients experienced postinfusion bleeding, and two patients (13%) showed renal dysfunction in the absence of biopsy-proven rejection. CONCLUSIONS: One infusion achieves good glycemic control and sometimes insulin independence. However, double-graft patients remain insulin-free longer, tend to have lower HbA1c, and show better graft function 24 months after transplant.
Keywords
Adult, Blood Glucose/*metabolism, C-Peptide/blood, Diabetes Mellitus, Type 1/drug therapy/metabolism/*surgery, Female, France, Glycated Hemoglobin A/*metabolism, Humans, Insulin/therapeutic use, Islets of Langerhans Transplantation/*methods/physiology, *Kidney Transplantation/physiology, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome
Pubmed
Create date
14/06/2021 8:58
Last modification date
12/01/2022 11:08
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