A Comparative Analysis of the Safety, Efficacy, and Cost of Islet Versus Pancreas Transplantation in Nonuremic Patients With Type 1 Diabetes. Issue 2 (23rd November 2015)

• Record Type: Journal Article
• Authors: Moassesfar, S.; Masharani, U.; Frassetto, L. A.; Szot, G. L.; Tavakol, M.; Stock, P. G.; Posselt, A. M.
• Is Part Of: American journal of transplantation. Volume 16:Issue 2(2016:Feb.)
• Page Start: 518
• Page End: 526
• Publication Date: 2015-11-23
• Subjects: clinical research -- practice -- islet transplantation -- pancreas -- simultaneous pancreas‐kidney -- type 1 -- islet isolation -- insulin -- C‐peptide -- islets of Langerhans; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.13536
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract: Few current studies compare the outcomes of islet transplantation alone (ITA) and pancreas transplantation alone (PTA) for type 1 diabetes (T1D). We examined these two beta cell replacement therapies in nonuremic patients with T1D with respect to safety, graft function and cost. Sequential patients received PTA (n = 15) or ITA (n = 10) at our institution. Assessments of graft function included duration of insulin independence; glycemic control, as measured by hemoglobin A1c; and elimination of severe hypoglycemia. Cost analysis included all normalized costs associated with transplantation and inpatient management. ITA patients received one (n = 6) or two (n = 4) islet transplants. Mean duration of insulin independence in this group was 35 mo; 90% were independent at 1 year, and 70% were independent at 3 years. Mean duration of insulin independence in PTA was 55 mo; 93% were insulin independent at 1 year, and 64% were independent at 3 years. Glycemic control was comparable in all patients with functioning grafts, as were overall costs ($138 872 for ITA, $134 748 for PTA). We conclude that with advances in islet isolation and posttransplant management, ITA can produce outcomes similar to PTA and represents a clinically viable option to achieve long‐term insulin independence in selected patients with T1D.