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Am J Transplant. 2018 Apr;18(4):945-951. doi: 10.1111/ajt.14514. Epub 2017 Nov 11.

Purity of islet preparations and 5-year metabolic outcome of allogenic islet transplantation.

Author information

1
Department of Endocrinology and Metabolism, CHRU Lille, Lille, France.
2
UMR 1190, Translational Research in Diabetes INSERM, Lille, France.
3
EGID (European Genomic Institute for Diabetes), Univ Lille, Lille, France.
4
Department of Endocrine Surgery, CHRU Lille, Lille, France.
5
Department of Biology, CHRU Lille, Lille, France.
6
Department of Nephrology and Transplantation, CHRU Lille, Lille, France.

Abstract

In allogenic islet transplantation (IT), high purity of islet preparations and low contamination by nonislet cells are generally favored. The aim of the present study was to analyze the relation between the purity of transplanted preparations and graft function during 5 years post-IT. Twenty-four patients with type 1 diabetes, followed for 5 years after IT, were enrolled. Metabolic parameters and daily insulin requirements were compared between patients who received islet preparations with a mean purity <50% (LOW purity) or ≥50% (HIGH purity). We also analyzed blood levels of carbohydrate antigen 19-9 (CA 19-9)-a biomarker of pancreatic ductal cells-and glucagon, before and after IT. At 5 years, mean hemoglobin A1c (HbA1c levels) (P = .01) and daily insulin requirements (P = .03) were lower in the LOW purity group. Insulin independence was more frequent in the LOW purity group (P < .05). CA19-9 and glucagon levels increased post-IT (P < .0001) and were inversely correlated with the degree of purity. Overall, our results suggest that nonislet cells have a beneficial effect on long-term islet graft function, possibly through ductal-to-endocrine cell differentiation. ClinicalTrial.gov NCT00446264 and NCT01123187.

KEYWORDS:

clinical research/practice; graft survival; islet isolation; islet transplantation; stem cells

PMID:
28941330
DOI:
10.1111/ajt.14514

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