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Acta Diabetologica

, Volume 51, Issue 5, pp 833–843 | Cite as

Five-year follow-up of patients with type 1 diabetes transplanted with allogeneic islets: the UIC experience

  • 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
  • Jose OberholzerEmail author
Original Article

Abstract

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.

Keywords

Type 1 diabetes Islet transplantation Immunosuppression Insulin independence 

Abbreviations

UIC

University of Illinios at Chicago

MMF

Mycophenolate mofetil

IEq

Islet equivalents

CITR

Collaborate islet transplant registry

TNF

Tumor necrosis factor

GLP-1

Glucagon-like peptide-1

MMT

Mixed meal test

OGTT

Oral glucose tolerance test

IVGTT

Intravenous glucose tolerance test

GST

Glucagon stimulation test

UACR

Urine albumin and creatinine ratio

Notes

Acknowledgments

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.

Ethical disclosure

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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Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • Meirigeng Qi
    • 1
  • Katie Kinzer
    • 1
  • Kirstie K. Danielson
    • 1
  • Joan Martellotto
    • 1
  • Barbara Barbaro
    • 1
  • Yong Wang
    • 1
  • James T. Bui
    • 2
  • Ron C. Gaba
    • 2
  • Grace Knuttinen
    • 2
  • Raquel Garcia-Roca
    • 1
  • Ivo Tzvetanov
    • 1
  • Andrew Heitman
    • 3
  • Maureen Davis
    • 1
  • James J. McGarrigle
    • 1
  • Enrico Benedetti
    • 1
  • Jose Oberholzer
    • 1
    Email author
  1. 1.Division of Transplantation, Department of SurgeryUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Department of RadiologyUniversity of Illinois at ChicagoChicagoUSA
  3. 3.The Emmes Corporation RockvilleRockvilleUSA

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