Primary Graft Function and 5 Year Insulin Independence After Pancreas and Islet Transplantation for Type 1 Diabetes: A Retrospective Parallel Cohort Study.

Mikael Chetboun (1) , Christophe Masset (2) , Mehdi Maanaoui (1) , Frédérique Defrance , Valery Gmyr (1) , Violeta Raverdy (1) , Thomas Hubert (1) , Caroline Bonner (1) , Lisa Supiot (3) , Clarisse Kerleau (2) , Giles Blancho (2, 3) , Julien Branchereau (2, 3) , Georges Karam (2, 3) , Ismaël Chelghaf (3) , Aurélie Houzet (2) , Magali Giral (2, 3) , Claire Garandeau (2) , Jacques Dantal (2, 3) , Kristell Le Mapihan (4) , Arnaud Jannin (5) , Marc Hazzan (6) , Robert Caiazzo (1) , Julie Pattou Kerr-Conte (1) , Marie-Christine Vantyghem (1) , Diego Cantarovich (2) , Francois Pattou (1)

1 RTD - Recherche translationnelle sur le diabète - U 1190
2 ITUN - Institut de transplantation urologie-néphrologie
3 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
4 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
5 CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277
6 LIRIC - Lille Inflammation Research International Center - U 995

In islet transplantation (ITx), primary graft function (PGF) or beta cell function measured early after last infusion is closely associated with long term clinical outcomes. We investigated the association between PGF and 5 year insulin independence rate in ITx and pancreas transplantation (PTx) recipients. This retrospective multicenter study included type 1 diabetes patients who underwent ITx in Lille and PTx in Nantes from 2000 to 2022. PGF was assessed using the validated Beta2-score and compared to normoglycemic control subjects. Subsequently, the 5 year insulin independence rates, as predicted by a validated PGF-based model, were compared to the actual rates observed in ITx and PTx patients. The study enrolled 39 ITx (23 ITA, 16 IAK), 209 PTx recipients (23 PTA, 14 PAK, 172 SPK), and 56 normoglycemic controls. Mean[SD] PGF was lower after ITx (ITA 22.3[5.2], IAK 24.8[6.4], than after PTx (PTA 38.9[15.3], PAK 36.8[9.0], SPK 38.7[10.5]), and lower than mean beta-cell function measured in normoglycemic control: 36.6[4.3]. The insulin independence rates observed at 5 years after PTA and PAK aligned with PGF predictions, and was higher after SPK. Our results indicate a similar relation between PGF and 5 year insulin independence in ITx and solitary PTx, shedding new light on long-term transplantation outcomes.

Mots clés: insulin independence; prediction; islet transplant; pancreas allograft; primary graft function

Domaines: Sciences du Vivant [q-bio]

Mikael Chetboun, Christophe Masset, Mehdi Maanaoui, Frédérique Defrance, Valery Gmyr, et al.. Primary Graft Function and 5 Year Insulin Independence After Pancreas and Islet Transplantation for Type 1 Diabetes: A Retrospective Parallel Cohort Study.. Transplant International, 2024, Transplant International, 36, pp.11950. ⟨10.3389/ti.2023.11950⟩. ⟨hal-04428805⟩