Survival After Islet Transplantation in Subjects With Type 1 Diabetes: Twenty-Year Follow-Up
Joana R. N. Lemos, David A. Baidal, Camillo Ricordi, Virginia Fuenmayor, Ana Alvarez, Rodolfo Alejandro
Abstract
Type 1 diabetes (T1D) is associated with premature mortality due to acute and chronic diabetes-related complications (1). Severe hypoglycemic events (SHEs) and impaired awareness of hypoglycemia are significant contributors to the increased morbidity and mortality. Islet transplantation (ITx) has been shown to provide near-normalization of glycemic control, restoration of hypoglycemia awareness, prevention of SHEs, and improved quality of life in a select group of patients with T1D (2). To analyze overall survival in ITx-alone recipients, we retrospectively evaluated a cohort of 49 T1D subjects who underwent ITx and were followed during 2000–2020. Subjects received ITx in the liver via intrahepatic infusion ( n = 46) or on the omentum via laparoscopic approach ( n = 3). Major inclusion criteria included age 18 to 65 years, T1D duration >5 years, impaired awareness of hypoglycemia, marked glycemic lability, and history of SHEs in the prior 12 months (2). Subjects who did not present the outcome were censored at last encounter. Deaths were reported through contact with family. The study cohort comprised 29 females (59.2%) and 20 males (40.8%). Person-years of follow-up was 610.1, and time after ITx was median (25th–75th) 13.8 (8.2–17.7) years. Median year (minimum–maximum) of T1D diagnosis was 1970 (1955–2001), with 77.6% ( n = 38) diagnosed in 1965 or later. Age at T1D diagnosis was median (25th–75th) 13.2 (6.7–20.0) …