Islet+Kidney Transplants Boost Survival in Type 1 Diabetes

TOPLINE:

Patients with type 1 diabetes who received transplanted islets along with a kidney transplant had significantly reduced mortality and transplant failure risks compared with those who received kidney alone and continued to use insulin.

METHODOLOGY:

  • Study population was all patients with type 1 diabetes in France who received a kidney transplant between 2000 and 2017.

  • Among 2393 patients, 327 were eligible for islet transplantation, including 47 who were actually transplanted with islets.

  • The subjects were matched for factors including year of transplantation, recipient age, kidney function, and A1c.

TAKEAWAY:

  • Those receiving islets along with the kidney transplant had a 53% lower risk of graft failure compared with the kidney-alone group.

  • Those receiving islet transplantation had a significantly higher estimated life expectancy during 10-year follow-up (9.61 vs 8.85 years).

  • At 1 year post islet transplant, there was an estimated 89.4% probability of graft survival and a 70.2% probability of achieving independence from insulin.

IN PRACTICE:

“Although islet transplantation has previously been shown to improve glycemic control compared with conventional insulin therapy in recent clinical trials, little was known about its long-term impact on patient prognosis until now.…These results are exciting and provide hope for people living with type 1 diabetes and kidney transplants.”

SOURCE :

Presented September 17, 2023, at the European Society for Organ Transplantation (ESOT) Congress 2023 by Mehdi Maanaoui, MD, a nephrologist at the University of Lille, Lille, France.

LIMITATIONS:

Observational, potential for residual confounding.

DISCLOSURES:

Maanaoui reports no relevant financial relationships.

Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape, with other work appearing in The Washington Post, NPR’s Shots blog, and Diabetes Forecast magazine. She is on Twitter @MiriamETucker.

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