Islet Transplantation

  • Sandrine LablancheEmail author
  • Camille Laporte
  • Pierre-Yves Benhamou


Type 1 diabetes mellitus is an autoimmune disease leading to an irreversible ß-cell deficit responsible for a complete insulin secretion deficiency. To date, no preventive or curative treatment for type 1 diabetes mellitus has been successfully translated to standard clinical care. Type 1 diabetes treatment is based on lifelong multi-daily injections of exogenous insulin. In the last decades, considerable improvements in diabetes management have occurred: thanks to an intensive disease management and the widespread use of new therapies such as new insulin formulations and new medical devices (insulin pump, real-time continuous glucose monitoring system, improved glucose monitoring system), the overall glycemic control of patients with type 1 diabetes has improved, and the incidence of long-term diabetic complications and the mortality of type 1 diabetic patients have decreased.


  1. 1.
    Beck RW, et al. The T1D Exchange clinic registry. J Clin Endocrinol Metab. 2012;97(12):4383–9.CrossRefGoogle Scholar
  2. 2.
    Lind M, et al. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014;371(21):1972–82.CrossRefGoogle Scholar
  3. 3.
    Livingstone SJ, et al. Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008–2010. JAMA. 2015;313(1):37–44.CrossRefGoogle Scholar
  4. 4.
    Gruessner AC, Gruessner RW. Pancreas transplant outcomes for United States and non United States cases as reported to the United Network for Organ Sharing and the International Pancreas Transplant Registry as of December 2011. Clin Transpl. 2012:23–40.Google Scholar
  5. 5.
    Benhamou PY, et al. Quality of life after islet transplantation: data from the GRAGIL 1 and 2 trials. Diabet Med. 2009;26(6):617–21.CrossRefGoogle Scholar
  6. 6.
    Tanenberg RJ, Newton CA, Drake AJ. Confirmation of hypoglycemia in the “dead-in-bed” syndrome, as captured by a retrospective continuous glucose monitoring system. Endocr Pract. 2010;16(2):244–8.CrossRefGoogle Scholar
  7. 7.
    McCoy RG, et al. Increased mortality of patients with diabetes reporting severe hypoglycemia. Diabetes Care. 2012;35(9):1897–901.CrossRefGoogle Scholar
  8. 8.
    Barr CC. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive insulin therapy, by The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. N Engl J Med. 2000;342:381–9. Surv Ophthalmol. 2001;45(5):459–60.CrossRefGoogle Scholar
  9. 9.
    Spijker HS, et al. Islet-after-lung transplantation in a patient with cystic fibrosis-related diabetes. Diabetes Care. 2014;37(7):e159–60.CrossRefGoogle Scholar
  10. 10.
    Ricordi C, et al. Automated method for isolation of human pancreatic islets. Diabetes. 1988;37(4):413–20.CrossRefGoogle Scholar
  11. 11.
    Yamamoto T, et al. Quality control for clinical islet transplantation: organ procurement and preservation, the islet processing facility, isolation, and potency tests. J Hepatobiliary Pancreat Surg. 2009;16(2):131–6.CrossRefGoogle Scholar
  12. 12.
    Services USDoHaH, Administration FaD, Research CfBEa. Guidance for industry: Considerations for allogeneic pancreatic islet cell products. 2009.Google Scholar
  13. 13.
    Badet L, et al. Expectations and strategies regarding islet transplantation: metabolic data from the GRAGIL 2 trial. Transplantation. 2007;84(1):89–96.CrossRefGoogle Scholar
  14. 14.
    Brons G. One more step along the road. Transplantation. 2007;84(1):15–6.CrossRefGoogle Scholar
  15. 15.
    Rickels MR, et al. Defining outcomes for beta-cell replacement therapy in the treatment of diabetes: a consensus report on the Igls criteria from the IPITA/EPITA opinion leaders workshop. Transpl Int. 2018;31(4):343–52.CrossRefGoogle Scholar
  16. 16.
    Lehmann R, et al. Has time come for new goals in human islet transplantation? Am J Transplant. 2008;8(6):1096–100.CrossRefGoogle Scholar
  17. 17.
    Hering BJ, et al. Phase 3 trial of transplantation of human islets in type 1 diabetes complicated by severe hypoglycemia. Diabetes Care. 2016;39(7):1230–40.CrossRefGoogle Scholar
  18. 18.
    Lablanche S, et al. Islet transplantation versus insulin therapy in patients with type 1 diabetes with severe hypoglycaemia or poorly controlled glycaemia after kidney transplantation (TRIMECO): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2018;6(7):527–37.CrossRefGoogle Scholar
  19. 19.
    Lablanche S, et al. Five-year metabolic, functional, and safety results of patients with type 1 diabetes transplanted with allogenic islets within the Swiss-French GRAGIL Network. Diabetes Care. 2015;38(9):1714–22.CrossRefGoogle Scholar
  20. 20.
    Shapiro AM, et al. Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen. N Engl J Med. 2000;343(4):230–8.CrossRefGoogle Scholar
  21. 21.
    Linetsky E, et al. Improved human islet isolation using a new enzyme blend, liberase. Diabetes. 1997;46(7):1120–3.CrossRefGoogle Scholar
  22. 22.
    Barton FB, et al. Improvement in outcomes of clinical islet transplantation: 1999–2010. Diabetes Care. 2012;35(7):1436–45.CrossRefGoogle Scholar
  23. 23.
    Bellin MD, et al. Prolonged insulin independence after islet allotransplants in recipients with type 1 diabetes. Am J Transplant. 2008;8(11):2463–70.CrossRefGoogle Scholar
  24. 24.
    Bellin MD, et al. Potent induction immunotherapy promotes long-term insulin independence after islet transplantation in type 1 diabetes. Am J Transplant. 2012;12(6):1576–83.CrossRefGoogle Scholar
  25. 25.
    Biarnes M, et al. Beta-cell death and mass in syngeneically transplanted islets exposed to short- and long-term hyperglycemia. Diabetes. 2002;51(1):66–72.CrossRefGoogle Scholar
  26. 26.
    Fiorina P, et al. Islet transplantation is associated with an improvement of cardiovascular function in type 1 diabetic kidney transplant patients. Diabetes Care. 2005;28(6):1358–65.CrossRefGoogle Scholar
  27. 27.
    Bassi R, Fiorina P. Impact of islet transplantation on diabetes complications and quality of life. Curr Diab Rep. 2011;11(5):355–63.CrossRefGoogle Scholar
  28. 28.
    Fiorina P, et al. Islet transplantation is associated with improvement of renal function among uremic patients with type I diabetes mellitus and kidney transplants. J Am Soc Nephrol. 2003;14(8):2150–8.CrossRefGoogle Scholar
  29. 29.
    Andres A, et al. Impairment of renal function after islet transplant alone or islet-after-kidney transplantation using a sirolimus/tacrolimus-based immunosuppressive regimen. Transpl Int. 2005;18(11):1226–30.CrossRefGoogle Scholar
  30. 30.
    Fung MA, et al. The effect of medical therapy and islet cell transplantation on diabetic nephropathy: an interim report. Transplantation. 2007;84(1):17–22.CrossRefGoogle Scholar
  31. 31.
    Kawahara T, et al. Portal vein thrombosis is a potentially preventable complication in clinical islet transplantation. Am J Transplant. 2011;11(12):2700–7.CrossRefGoogle Scholar
  32. 32.
    Collaborative islet transplant registry, Ninth annual report. 2016.
  33. 33.
    Dominguez-Bendala J, et al. The human endocrine pancreas: new insights on replacement and regeneration. Trends Endocrinol Metab. 2016;27(3):153–62.CrossRefGoogle Scholar
  34. 34.
    Calafiore R, et al. Microencapsulated pancreatic islet allografts into nonimmunosuppressed patients with type 1 diabetes: first two cases. Diabetes Care. 2006;29(1):137–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sandrine Lablanche
    • 1
    • 2
    Email author
  • Camille Laporte
    • 2
  • Pierre-Yves Benhamou
    • 1
    • 2
  1. 1.Department of DiabetologyCHU Grenoble AlpesGrenobleFrance
  2. 2.Laboratory of Fundamental and Applied BioenergeticsGrenoble Alpes UniversityGrenobleFrance

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