Islet transplantation is not a new concept, but it is one that scientists are continually trying to refine and improve. A major challenge with this procedure is rejection or destruction of the transplanted cells. However, researchers followed up with a group of 28 patients who had undergone islet transplantation and found that 10 years later, there were still lasting benefits.
A recent study looked on how patients fared a decade after receiving transplants. Fourteen of the patients received only an islet transplant, while the other 14 had a kidney graft in addition to the islet transplant. Regardless of procedure, researchers found that “28% remained completely independent of exogenous insulin” after 10 years, a slight decrease from the 39% who were independent of insulin use after five years. However, even those participants who did return to needing insulin had improved glycemic control and a lower exogenous insulin requirement than prior to transplantation. In addition, they had fewer severe hypoglycemic events.
A major factor in the effectiveness of the transplant was graft function. Those individuals who had optimal graft function maintained insulin independence longer than those who had poorer graft function. Immunosuppression was used to help support graft survival, but there were some serious adverse events as a result. In the 28 participants, there were eight instances of infections or skin carcinomas and 11 diabetes-related events that were cardiovascular.
Five participants experienced symptomatic cardiovascular events and six experienced asymptomatic myocardial ischemia. One person died of a stroke. However, researchers report that “mortality rate in patients similar to those in the current study but who did not undergo islet transplantation is three to four times higher with causes of death largely being severe hypoglycemia or ischemic heart disease.”
It is encouraging to see that a decade after islet transplantation, participants are still experiencing positive outcomes in regarding to diabetes management, with some maintaining insulin independence. As researchers continue to learn more and are able to refine and improve islet transplantation, more patients may benefit long-term from this treatment option and potentially achieve insulin independence.
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