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Ten-years outcomes of islet transplantation in patients with type 1 diabetes: data from the Swiss-French GRAGIL network

S. Lablanche 1, 2, 3, 4 S. Borot 5 A. Wojtusciszyn 6 K. Skaare 7, 3, 8 A. Penfornis 9 P. Malvezzi 8 L. Badet 10 C. Thivolet 11 E. Morelon 10 F. Buron 10 E. Renard 6 I. Tauveron 12, 13, 14 O. Villard 6 M. Munch 15, 16, 17, 18 S. Sommacal 4, 8 L. Clouaire 4, 8 M. Jacquet 4, 8 L. Gonsaud 4, 8 C. Camillo-Brault 10, 19 C. Colin 10, 19 J. L. Bosson 7, 3, 8 D. Bosco 20 T. Berney 20 L. Kessler 16, 17 P. Y. Benhamou 1, 2, 3, 4
Abstract : To describe the 10-year outcomes of islet transplantation within the Swiss-French GRAGIL Network, in patients with type 1 diabetes experiencing high glucose variability associated with severe hypoglycemia and/or with functional kidney graft. We conducted a retrospective analysis of all subjects transplanted in the GRAGIL-1c and GARGIL-2 islet transplantation trials and analyzed components of metabolic control, graft function and safety outcomes over the 10-year period of follow-up. Forty-four patients were included between September 2003 and April 2010. Thirty-one patients completed a ten-year follow-up. Ten years after islet transplantation, median HbA1c was 7.2% [6.2-8.0] (55 mmol/mol [44-64]) vs 8.0% [7.1-9.1] (64 mmol/mol [54-76]) before transplantation (p\textless0.001). 17/23 (73.9%) recipients were free of severe hypoglycemia, 1/21 patient (4.8%) was insulin-independent and median C-peptide was 0.6 ng/ml [0.2-1.2]. Insulin requirements (UI/kg/day) were 0.3 [0.1-0.5] vs 0.5 [0.4-0.6] before transplantation (p\textless0.001). Median [IQR] β-score was 1 [0-4] (p\textless0.05 when comparing with pre-transplantation values) and 51.9% recipients had a functional islet graft at 10 years. With a 10-year follow up in a multicentric network, islet transplantation provided sustained improvement of glycemic control and was efficient to prevent severe hypoglycemia in almost 75% of the recipients.
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Submitted on : Wednesday, September 15, 2021 - 7:34:23 AM
Last modification on : Friday, September 17, 2021 - 3:35:12 AM

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S. Lablanche, S. Borot, A. Wojtusciszyn, K. Skaare, A. Penfornis, et al.. Ten-years outcomes of islet transplantation in patients with type 1 diabetes: data from the Swiss-French GRAGIL network. American Journal of Transplantation, Wiley, 2021, Online ahead of print. ⟨10.1111/ajt.16637⟩. ⟨inserm-03344373⟩

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