Islet Transplantation in Type 1 Diabetics Using a Novel Immunouspressive Regimen

Strategic Insights -

Researchers from the University of California have successfully conducted islet transplantation in type 1 diabetics using a novel immunosuppressive regimen based on the anti-LFA-1 antibody efalizumab. This study demonstrated that insulin independence after islet transplantation can be achieved with a corticosteroid- and calcineurin inhibitor-free regimen, which may minimize renal and islet toxicity and improve long-term islet allograft survival.

Key Takeaways:

  • Eight patients with type 1 diabetes and hypoglycemic unawareness received intraportal allogeneic islet transplants, resulting in all patients achieving insulin independence.
  • Four out of eight patients became independent after single-islet transplants, with no further hypoglycemic events, decreased hemoglobin A1c levels, and stable renal function.
  • The novel immunosuppressive regimen consisted of antithymocyte globulin induction followed by maintenance with efalizumab and sirolimus or mycophenolate.
  • When efalizumab was withdrawn from the market, all patients were transitioned to regimens consisting of mycophenolate and sirolimus or mycophenolate and tacrolimus.
  • The researchers reported that efalizumab was well tolerated and no serious adverse events were encountered.
  • The study's results demonstrate the potential of this regimen to minimize renal and islet toxicity and improve long-term islet allograft survival.

Statistics:

  • 8 patients with type 1 diabetes and hypoglycemic unawareness received intraportal allogeneic islet transplants.
  • 4 out of 8 patients became independent after single-islet transplants.
  • 0 further hypoglycemic events occurred in insulin-independent patients.
  • Hemoglobin A1c levels decreased in all patients who achieved insulin independence.
  • Renal function remained stable in all patients who achieved insulin independence.

Sources:

  • Posselt AM, et al. Islet transplantation in type 1 diabetics using an immunosuppressive protocol based on the anti-LFA-1 antibody efalizumab. American Journal of Transplantation, 2010;10(8):1870-80.