Islet Product Characteristics and Factors Related to Successful Human Islet Transplantation From the Collaborative Islet Transplant Registry (CITR) 1999–2010

Abstract

The Collaborative Islet Transplant Registry (CITR) collects data on clinical islet isolations and transplants. This retrospective report analyzed 1017 islet isolation procedures performed for 537 recipients of allogeneic clinical islet transplantation in 1999–2010. This study describes changes in donor and islet isolation variables by era and factors associated with quantity and quality of final islet products. Donor body weight and BMI increased significantly over the period (p < 0.001). Islet yield measures have improved with time including islet equivalent (IEQ)/particle ratio and IEQs infused. The average dose of islets infused significantly increased in the era of 2007–2010 when compared to 1999–2002 (445.4 ± 156.8 vs. 421.3 ± 155.4 ×103 IEQ; p < 0.05). Islet purity and total number of β cells significantly improved over the study period (p < 0.01 and <0.05, respectively). Otherwise, the quality of clinical islets has remained consistently very high through this period, and differs substantially from nonclinical islets. In multivariate analysis of all recipient, donor and islet factors, and medical management factors, the only islet product characteristic that correlated with clinical outcomes was total IEQs infused. This analysis shows improvements in both quantity and some quality criteria of clinical islets produced over 1999–2010, and these parallel improvements in clinical outcomes over the same period.

Islet transplantation promotes podocyte regeneration in a model of diabetic nephropathy

“…These overexpressions persistently promote podocyte and PEC apoptosis and hamper the differentiation of PECs into podocytes that repair damage in advanced DN. Normal control of BG after IT has been verified in earlier studies (22,23). The results of the present study also indicate that IT exhibited increased benefits in terms of repairing glomerular structure and kidney fibrosis, more so than insulin therapy in DN model rats.…”

Xenotransplantation for Islets from Clinical Side

“…Gram stain prior to transplantation, as well as to a glucose stimulation index (ratio of stimulated insulin secretion/basal insulin secretion) ≥1 [39,40]. Criteria based on these are currently, in formal, applied at the institution for cell transplantation and gene therapy at the 3rd Xiangya Hospital of Central South University, China, where we require each islet preparation from neonatal pigs to reach the determined thresholds of islet number/mass, viability, purity, and sterility before the product is released for transplantation [41].…”

Clinical Islet Cell Transplantation – Recent Advances

“… CIT-01: Open randomized multicentre study to evaluate the safety and efficacy of low-molecular-weight sulphated dextran in islet transplantation (Nordic countries 14 stated that 44% of islet allotransplant recipients were insulin-independent three years after receiving an islet graft from 2007 to 2010 (refs 15, 16). However, few islet processing facilities perform islet allotransplants in the United States because of classification of the treatment as an experimental therapy and not a clinical therapy.…”