Influence of islet transportation on pancreatic islet allotransplantation in type 1 diabetic patients within the swiss-french GRAGIL network

Background. The influence of islet transportation on pancreatic islet allotransplantation in type 1 diabetic patients was evaluated within the GRAGIL network. Patients and Methods. From December 2001 to April 2003, 16 human pancreatic islet transplants were performed in 9 type I diabetic patients with an established kidney graft (functioning for at least 6 months) in four centers of the GIRAGIL network. Islet isolation was performed in a core laboratory in Geneva, and the islet preparations were shipped by ambulance to each center for transplantation. One month after transplantation, the efficiency of the graft was assessed according to islet transportation time (ITT): ITT less than 2 hours (group 1, n = 5), and ITT greater than 4.5 hours (group 2, n = 4, mediant 5 hours). Results. Primary graft dysfunction was observed in one patient in group 1 after one month. Two patients became insulin independent in groups I and 2. All other patients in both groups had a plasma C-peptide level greater than 0.5 ng/ml. The RbA(1c) level and the exogenous insulin needs decreased in both groups. Conclusions. ITT does not seem to influence the efficiency of pancreatic islet allotransplantation in type 1 diabetic patients. These results emphasize the scope for multicenter networks such as the GRAGIL group.