3 years ago

Purity of islet preparations and 5-year metabolic outcome of allogenic islet transplantation

D'Herbomez, F Pattou, C Noel, M C Vantyghem, V Gmyr, M Chetboun, P Pigny, K Le Mapihan, F Torres, C Bonner, R Caiazzo, A Jannin, J Kerr-Conte, V Raverdy, S Espiard, K Benomar
In allogenic islet transplantation (IT), high purity of islet preparations and low contamination by non-islet cells are generally favored. The aim of the present study was to analyze the relation between the purity of transplanted preparations, and graft function during 5 years post-IT. Twenty-four type 1 diabetic patients, followed-up 5 years after IT, were enrolled. Metabolic parameters and daily insulin requirements were compared between patients who received islet preparations with a mean purity < 50% (LOW purity) or ≥50% (HIGH purity). We also analyzed blood levels of carbohydrate 19-9 (CA 19-9) - a biomarker of pancreatic ductal cells - and glucagon, before and after IT. At 5 years, mean HbA1c levels (p=0.01) and daily insulin requirements (p=0.03) were lower in the LOW purity group. Insulin independence was more frequent in the LOW purity group (p<0.05). CA19-9 and glucagon levels increased post-IT (p<0.0001), and were inversely correlated with the degree of purity. Overall, our results suggest that non-islet cells have a beneficial effect on long-term islet graft function, possibly through glucagon to mediate ductal to endocrine cell differentiation. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/ajt.14514

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