Article Dans Une Revue American Journal of Transplantation Année : 2022

Feasibility and efficacy of combined pancreatic islet-lung transplantation in cystic fibrosis-related diabetes–PIM study: A multicenter phase 1–2 trial

Dominique Grenet
  • Fonction : Auteur
Michel Greget
  • Fonction : Auteur
Iulian Enescu
  • Fonction : Auteur
Florence Bouilloud
  • Fonction : Auteur
Pierre Bonnette
  • Fonction : Auteur
Axel Guth
  • Fonction : Auteur
Domenico Bosco
  • Fonction : Auteur
Catherine Mercier
  • Fonction : Auteur
Thierry Berney
Pierre Yves Benhamou
Gilbert Massard
  • Fonction : Auteur
Coralie Camilo
  • Fonction : Auteur
Cyrille Colin
  • Fonction : Auteur
Cécile Arnold
  • Fonction : Auteur

Résumé

Cystic fibrosis-related diabetes (CFRD) is a common complication of cystic fibrosis (CF), and restoring metabolic control in these patients may improve their management after lung transplantation. In this multicenter, prospective, phase 1–2 trial, we evaluate the feasibility and metabolic efficacy of combined pancreatic islet-lung transplantation from a single donor in patients with CFRD, terminal respiratory failure, and poorly controlled diabetes. Islets were infused via the portal vein under local anesthesia, 1week after lung transplantation. At 1 year, the primary outcome was transplant success as evaluated by a composite score including four parameters (weight, fasting glycemia, HbA1c, and insulin requirements). Ten participants (age: 24 years [17–31], diabetes duration: 8 years [4–12]) received a combined islet-lung transplant with 2892 IEQ/kg [2293–6185]. Transplant success was achieved in 7 out of 10 participants at 1y-ear post transplant. Fasting plasma C-peptide increased from 0.91 μg/L [0.56–1.29] to 1.15 μg/L [0.77–2.2], HbA1c decreased from 7.8% [6.5–8.3] (62 mmol/mol [48–67]) to 6.7% [5.5–8.0] (50 mmol/mol [37–64]), with 38% decrease in daily insulin doses. No complications related to the islet injection procedure were reported. In this pilot study, combined pancreatic islet-lung transplantation restored satisfactory metabolic control and pulmonary function in patients with CF, without increasing the morbidity of lung transplantation.

Fichier principal
Vignette du fichier
PIIS1600613522082752.pdf (424.56 Ko) Télécharger le fichier
Origine Fichiers éditeurs autorisés sur une archive ouverte
Licence

Dates et versions

hal-04176576 , version 1 (21-06-2024)

Licence

Identifiants

Citer

Luc Rakotoarisoa, Clothilde Wagner, Marion Munch, Benjamin Renaud Picard, Dominique Grenet, et al.. Feasibility and efficacy of combined pancreatic islet-lung transplantation in cystic fibrosis-related diabetes–PIM study: A multicenter phase 1–2 trial. American Journal of Transplantation, 2022, 22 (7), pp.1861-1872. ⟨10.1111/ajt.17058⟩. ⟨hal-04176576⟩
83 Consultations
97 Téléchargements

Altmetric

Partager

  • More