Five-year follow-up of patients with type 1 diabetes transplanted with allogeneic islets: the UIC experience
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This report summarizes a 5-year phase 1/2 allogeneic islet transplantation clinical trial conducted at the University of Illinois at Chicago (UIC). Ten patients were enrolled in this single center, open label, and prospective trial in which patients received 1–3 transplants. The first four subjects underwent islet transplantation with the Edmonton immunosuppressive regimen and the remaining six subjects received the UIC immunosuppressive protocol (Edmonton plus etanercept and exenatide). All 10 patients achieved insulin independence after 1–3 transplants. At 5 years of follow-up, 6 of the initial 10 patients were free of exogenous insulin. During the follow-up period, 7 of the 10 patients maintained positive C-peptide levels and a composite hypoglycemic score of 0. Most patients maintained HbA1c levels <6.0 % (42.1 mmol/mol) and a significantly improved β-score. In conclusion, this study demonstrated long-term islet graft function without using T cell depleting induction, with an encouraging outcome that includes 60 % of patients remaining insulin independent after 5 years of initial transplantation.
KeywordsType 1 diabetes Islet transplantation Immunosuppression Insulin independence
University of Illinios at Chicago
Collaborate islet transplant registry
Tumor necrosis factor
Mixed meal test
Oral glucose tolerance test
Intravenous glucose tolerance test
Glucagon stimulation test
Urine albumin and creatinine ratio
This work was supported by funding from the College of Medicine, University of Illinois at Chicago. J.O. and J. M. were supported by the Islet Cell Resources Center NIH grant (5 U42 RR023245-02), the Christopher Family Foundation, and the Efroymson Foundation. The subjects are evaluated at the UIC Clinical Research Center, which is supported by the University of Illinois at Chicago Center for Clinical and Translational Science (Award Number UL1RR029879) from the National Center for Research Resources. Data acquisition aided by the CITR, Emmes corporation. The islet program was supported by the Chicago Diabetes Project, and the Washington Square Health Foundation.
Conflict of interest
Meirigeng Qi, Katie Kinzer, Kirstie K. Danielson, Joan Martellotto, Barbara Barbaro, Yong Wang, James T. Bui, Ron C. Gaba, Grace Knuttinen, Raquel Garcia-Roca, Ivo Tzvetanov, Andrew Heitman, Maureen Davis, James J. McGarrigle, Enrico Benedetti, and Jose Oberholzer declare that they have no conflict of interest.
All human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki.
Human and animal rights disclosure
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).
Informed consent disclosure
Informed consent was obtained from all patients for being included in the study.
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