A new study, focused on the analysis of long-term results of pancreatic islets transplant in patients with type 1 diabetes, has been published in The Lancet Diabetes & Endocrinology.

The study, coordinated by Lorenzo Piemonti, Head of the Regenerative Medicine and Transplant Unit, Director of Diabetes Research Institute (DRI) at IRCCS San Raffaele University Hospital and Associate Professor in Endocrinology at Vita-Salute San Raffaele University, is one of the widest single-centered retrospective analysis in the world, with a twenty-year follow-up, and provides important indications for future therapies of of beta-cells replacement in patients with type 1 diabetes.

The study involved 79 patients, from 18 to 67 years, who underwent treatments at IRCCS Ospedale San Raffaele from 2001 to 2023. The analysis revealed a significant improvement in transplant survival and a higher independence from insulin in people with type 1 diabetes that had received a dose of pancreatic islets of at least 10.000 IEQ/kg and the immunosuppressive protocol αCD25/FK506/Rapa. In this group, average islets survival was 9,7 years, with 72,7% of patients maintaining insulin independence for 6-7 years.

Data show an islet survival of 86% up to one year from transplant, of 65% up to five years and of 40% up to twenty years, confirming long-term efficacy of the treatment. However, the study has highlighted some side effects associated to the immunosuppressive therapy, like infections and a reduction of the renal functionality, which require a careful monitoring and targeted interventions to guarantee long-term safety of patients.

“This study highlights the potential of islets transplant in improving the quality of life of patients suffering from long-term diabetes, providing at the same time valuable indications for the optimization of future cellular therapies, in particular those based on the differentiation of pancreatic islets from stem cells”, explains Professor Piemonti. “The results enable not only a better understanding of the effects of immunosuppression, but also the definition of the optimal islet doses for safe and effective transplants. These data underline the importance of research to improve cellular therapies addressed to patients with type 1 diabetes, to ensure treatments that are effective in the long period”, concludes Professor Piemonti.