Long-term Outcomes With Islet-Alone and Islet-After-Kidney Transplantation for Type 1 Diabetes in the Clinical Islet Transplantation Consortium: The CIT-08 Study

作者：Michael Roehrhoff Rickels, Thomas L. Eggerman, Levent Bayman, Julie C. Qidwai, Rodolfo Alejandro, Nancy D. Bridges, Bernhard J. Hering, James F. Markmann, Peter Alexander Senior, Lawrence G. Hunsicker, José G. Ávila, Beth Begley, Jose Cano, Sallie Carpentier, Elizabeth Holbrook, Jennifer A. Hutchinson, Christian P. Larsen, Johanna Moreno, Marti H. Sears, Nicole A. Turgeon, Dasia Webster, Christian Berne, Carl Jorns, Torbjörn Lundgren, Mikael Rydén, Enrico Cagliero, Kerry A. Crisalli, Shan Deng, Ji Lei, James F. Markmann, David M. Nathan, Patrice C. Al-Saden, Jason Battle, Xioajuan Chen, Angela Hecyk, Dixon B. Kaufman, Herman Kissler, Xunrong Luo, Mark E. Molitch, Natalie Monson, Elyse Stuart, Amisha Wallia, Ling‐Jia Wang, Shusen Wang, Xiaomin Zhang, Nancy D. Bridges, Christine W. Czarniecki, Julia Goldstein, Tomeka Granderson, Yvonne Morrison, Allison Priore, Gerry Putz, Mark A. Robien, Elizabeth M. Schneider, Guillermo Arreaza, Thomas L. Eggerman, Neal Green, David L. Bigam, Patricia M Campbell, Parastoo Dinyari, Sharleen Imes, Tatsuya Kin, Norman M. Kneteman, Angela Koh, James G. Lyon, Andrew J. Malcolm, Doug O’Gorman, Chris Onderka, Richard J Owen, Rena L. Pawlick, Brad Richer, Shawn Rosichuk, Edmond A. Ryan, Donna Sarman, Adam Schroeder, Peter Alexander Senior, A. M. James Shapiro, Lana Toth, Vali Toth, Wendy Zhai, Kristina Johnson, Joan McElroy, Andrew M. Posselt, Marissa Ramos, Tara Rojas, Peter G. Stock, Gregory L. Szot, Barbara Barbaro, Leelama George, Joan Martellotto, José Oberholzer, Meirigeng Qi, Yong Wang, Levent Bayman, Kathryn M. Chaloner, William R. Clarke, Joseph Stephen Dillon, Cynthia Diltz, Gregory C. Doelle, Dixie J. Ecklund, Holly Ernst, Deb Feddersen, Eric D. Foster, Lawrence G. Hunsicker, Carol Jasperson, David-Erick Lafontant, Karen D. McElvany, Tina Neill-Hudson, Deb Nollen, Julie C. Qidwai, Traci Schwieger, Beth A. Shields, Jamie Willits, Jon W. Yankey, Rodolfo Alejandro, Ana M.ª Mañá Álvarez, Andrea Curry Corrales, Raquel N. Faradji, Tatiana Froud, Ana Alvarez Gil, Eva Herrada, Hirohito Ichii, Luca Inverardi, Norma Sue Kenyon, Aisha Khan, Elina Linetsky, J. Montelongo, Eduardo Moraes Leao Peixoto, Kathryn Peterson, Camillo Ricordi, Joel Szust, Xiaoling Wang, Xiumin Xu, Muhamad H. Abdulla, Jeffrey D. Ansite, Appakalai N. Balamurugan, Melena D. Bellin, Mary Brandenburg, T Gilmore, James Vail Harmon, Bernhard J. Hering, Raja Kandaswamy, Gopal Loganathan, Kate R. Mueller, Klearchos K. Papas, J Højgaard Pedersen, Joshua J. Wilhelm, Jean C. Witson, Aksel Espen Foss, Trond Geir Jenssen, Cornelia Dalton-Bakes, Hongxing Fu, Malek Kamoun, Jane D. Kearns, Yanjing Li, Chengyang Liu, Eline Luning-Prak, Yanping Luo, Eileen Markmann, Zaw Min, Ali Hadi Naji, Maral Palanjian, Michael Roehrhoff Rickels, Richard D. Shlansky-Goldberg, Kumar Vivek, Amin Sam Ziaie, Peter Chebleck, Juan Sebastian Danobeitia, Luis Fernandez Dixon B. Kaufman, Jon S. Odorico, Kristi L. Schneider, Laura Jo Zitur, Daniel Brandhorst, A. Friiberg, Olle Korsgren, Bo Nilsson, Gunnar Tufveson, Bengt von Zur-MΈhlen, Irene D. Feurer · 发表于：Diabetes Care · 年份：2022 · DOI：10.2337/dc21-2688 · 被引用次数：52 · 研究领域：Pancreatic function and diabetes、Diabetes and associated disorders、Diabetes Management and Research

OBJECTIVE: To determine long-term outcomes for islet-alone and islet-after-kidney transplantation in adults with type 1 diabetes complicated by impaired awareness of hypoglycemia. RESEARCH DESIGN AND METHODS: This was a prospective interventional and observational cohort study of islet-alone (n = 48) and islet-after-kidney (n = 24) transplant recipients followed for up to 8 years after intraportal infusion of one or more purified human pancreatic islet products under standardized immunosuppression. Outcomes included duration of islet graft survival (stimulated C-peptide ≥0.3 ng/mL), on-target glycemic control (HbA1c <7.0%), freedom from severe hypoglycemia, and insulin independence. RESULTS: Of the 48 islet-alone and 24 islet-after-kidney transplantation recipients, 26 and 8 completed long-term follow-up with islet graft function, 15 and 7 withdrew from follow-up with islet graft function, and 7 and 9 experienced islet graft failure, respectively. Actuarial islet graft survival at median and final follow-up was 84% and 56% for islet-alone and 69% and 49% for islet-after-kidney (P = 0.007) with 77% and 49% of islet-alone and 57% and 35% of islet-after-kidney transplantation recipients maintaining posttransplant HbA1c <7.0% (P = 0.0017); freedom from severe hypoglycemia was maintained at >90% in both cohorts. Insulin independence was achieved by 74% of islet-alone and islet-after-kidney transplantation recipients, with more than one-half maintaining insulin independence during ...