Long‐term outcome of islet transplantation on insulin‐dependent diabetes mellitus: An observational cohort study

Aims/Introduction To investigate the long‐term efficacy and safety of islet transplantation (ITx) compared with multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). Materials and Methods Among 619 patients diagnosed as insulin‐dependent diabetes mellitus or type 1 diabetes at Kyoto University, Kyoto, Japan, seven patients were selected as the ITx group and 26 age‐matched patients with no endogenous insulin secretion were selected as the MDI/CSII group. Hemoglobin A1c, aspartate aminotransferase/alanine aminotransferase (AST/ALT) and creatinine were assessed retrospectively at 1, 2, 5 and 10 years for both groups; serum C‐peptide immunoreactivity was assessed for the ITx group. Major clinical events were also assessed. Results Hemoglobin A1c improvement in ITx was significant at 1 year (8.4% [7.8–9.9%] at baseline to 7.1% [6.3–7.4%] in ITx vs 8.2% [7.4–9.8%] at baseline to 8.1% [7.3–9.5%] in MDI/CSII, P
This study focuses on the efficacy, possible adverse events and effects on major organ function of islet transplantation during 10‐year follow up, in comparison with conventional insulin therapy. Islet transplantation achieved an improvement in glycemic control corresponding to graft function and a tendency to reduction of severe hypoglycemia, with tolerable, but attention‐requiring, risks, such as transient elevation of transaminase, infectious disease, digestive symptoms and malignancy, and with no mortality.