- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT07666789
Efficacy of Islet Re-transplantation After Failure of Beta-cell Replacement (MULT-ILOT)
Efficacy and Safety of Islet Re-transplantation After Failure of Beta-cell Replacement
Islet transplantation and pancreas transplantation are established therapeutic options for selected individuals with type 1 diabetes experiencing severe glycemic instability and recurrent hypoglycemia. Although these approaches significantly improve glycemic management and quality of life, long-term graft survival remains limited, with a progressive decline in beta-cell function over time.
The clinical benefit-risk profile of islet re-transplantation after graft failure remains poorly defined, and outcomes following repeat islet transplantation after prior islet graft failure have not been specifically evaluated.
Repeated exposure to multiple donors may increase the risk of alloimmunization, including the development of donor-specific antibodies , which may adversely affect graft survival and limit access to future transplantation.
This multicenter retrospective cohort study aims to evaluate the efficacy and safety of islet re-transplantation in adults with type 1 diabetes after failure of initial beta-cell replacement (islet or pancreas transplantation), with outcomes assessed at 3 months, 1 year, and 5 years.
Panoramica dello studio
Stato
Tipo di studio
Iscrizione (Stimato)
Contatti e Sedi
Contatto studio
- Nome: Orianne OV Villard, MD
- Numero di telefono: +33 467 338 382
- Email: orianne.villard@chu-montpellier.fr
Backup dei contatti dello studio
- Nome: Roxane RD Descaillot
- Email: roxanedescaillot@gmail.com
Luoghi di studio
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Montpellier, Francia, 34000
- Reclutamento
- Montpellier University Hospital
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Contatto:
- Orianne OV Villard, MD
- Numero di telefono: +33 467 338 382
- Email: orianne.villard@chu-montpellier.fr
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Investigatore principale:
- Orianne OV Villard, MD
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Metodo di campionamento
Popolazione di studio
Descrizione
Inclusion Criteria:
- Age ≥ 18 years
- Diagnosis of type 1 diabetes
- Prior beta-cell replacement therapy : islet transplantation or pancreas transplantation
- Islet re-transplantation performed after 2005
- Islet re-transplantation performed after documented beta cell graft failure, defined by undetectable C-peptide and/or recurrence of severe hypoglycemia on insulin therapy
- Availability of clinical and biological data required for assessment of study outcomes
Exclusion Criteria:
- Missing or incomplete data preventing assessment of the primary outcome
- Patients who did not meet inclusion criteria
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Coorti e interventi
Gruppo / Coorte |
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Initial pancreas transplant
Islet after pancreas transplant failure
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Initial islet transplant
Islet after islet transplant failure
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Islet graft success
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Assessed using Igls criteria (optimal or good graft function classification) based on C-peptide, insulin use, hemoglobin A1c, and severe hypoglycemia
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Baseline, 3 months, 1 year, 5 years
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Glycemic Control_Glycated hemoglobin (HbA1c) level
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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HbA1c level, measured by HPLC method
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Baseline, 3 months, 1 year, 5 years
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Glycemic Control_Percentage of individuals with HbA1c < 7% and no severe hypoglycemia
Lasso di tempo: Baseline, 3 months, 12 months, 5 years
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Baseline, 3 months, 12 months, 5 years
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Beta-Cell Function_BETA-2 score
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Derived from fasting glucose, paired fasting C-peptide, insulin dose and Hba1c and generates a single value between 0 and 42
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Baseline, 3 months, 1 year, 5 years
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Beta-Cell Function_BETA score
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Derived from fasting glucose, HbA1c, stimulated C-peptide, and absence of insulin or oral hypoglycemic agent use and generates a single value between 0 and 8
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Baseline, 3 months, 1 year, 5 years
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Beta-Cell Function_Severe hypoglycemia events
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Percentage of individual with severe hypoglycemia events
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Baseline, 3 months, 1 year, 5 years
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Beta-Cell Function_Residual beta cell function
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Percentage of individual with fasting plasma C-peptide > 0.3 ng/mL
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Baseline, 3 months, 1 year, 5 years
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Immunological Outcomes_Donor-specific antibodies (DSA)
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Presence and specificity of donor-specific antibodies (DSA) with classification :
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Baseline, 3 months, 1 year, 5 years
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Immunological Outcomes_Autoantibodies
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Dosage of antibodies anti-GAD, anti-IA2, anti-insulin, and anti-ZnT8
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Baseline, 3 months, 1 year, 5 years
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Safety of islet re-transplantation_Procedural complications of islet infusions
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Reported of procedural complications of islet infusions such as portal thrombosis, hematoma, transfusion requirement
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Baseline, 3 months, 1 year, 5 years
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Safety of islet re-transplantation_Renal function eGFR
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Estimated GFR from serum creatinine level
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Baseline, 3 months, 1 year, 5 years
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Safety of islet re-transplantation_Albuminuria
Lasso di tempo: Baseline, 3 months, 1 year, 5 years
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Measurement of albuminuria or proteinuria
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Baseline, 3 months, 1 year, 5 years
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Safety of islet re-transplantation_Immunosuppression-related complications
Lasso di tempo: 3 months, 1 year, 5 years
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Reported immunosuppression-related complications such as infections ; malignancy, cardiovascular events
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3 months, 1 year, 5 years
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Safety of islet re-transplantation_Mortality
Lasso di tempo: 3 months, 1 year, 5 years
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Patient death
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3 months, 1 year, 5 years
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Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Glycemic control_Time in range (70-180 mg/dL)
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) measured time with glucose between 70 and 180 mg/dL
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Baseline, 3 months, 1 year and 5 years
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Glycemic control_Time in tight range (70-140 mg/dL)
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) measured time with glucose between 70 and 140 mg/dL
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Baseline, 3 months, 1 year and 5 years
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Glycemic control_Time below range 70 mg/dL
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) measured time with glucose between 70 and 54 mg/dL
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Baseline, 3 months, 1 year and 5 years
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Glycemic control_Time below range 54 mg/dL
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) measured time with glucose below 54 mg/dL
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Baseline, 3 months, 1 year and 5 years
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Glycemic control_Time above range 180 mg/dL
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) measured time with glucose between 180 and 250 mg/dL
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Baseline, 3 months, 1 year and 5 years
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Glycemic control_Time above range 250 mg/dL
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) measured time with glucose above 250 mg/dL
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Baseline, 3 months, 1 year and 5 years
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Glycemic control_Mean glucose
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) derived-metrics
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Baseline, 3 months, 1 year and 5 years
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Glycemic control_Coefficient of variation
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) derived-metrics
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Baseline, 3 months, 1 year and 5 years
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Glycemic control_Glycemic risk index
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) derived-metrics
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Baseline, 3 months, 1 year and 5 years
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Glycemic control_Glucose Management Indicator (GMI)
Lasso di tempo: Baseline, 3 months, 1 year and 5 years
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Continuous Glucose Monitoring (CGM) derived-metrics
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Baseline, 3 months, 1 year and 5 years
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Collaboratori e investigatori
Pubblicazioni e link utili
Pubblicazioni generali
- Chetboun M, Drumez E, Ballou C, Maanaoui M, Payne E, Barton F, Kerr-Conte J, Vantyghem MC, Piemonti L, Rickels MR, Labreuche J, Pattou F; Collaborative Islet Transplant Registry (CITR) Investigators study group. Association between primary graft function and 5-year outcomes of islet allogeneic transplantation in type 1 diabetes: a retrospective, multicentre, observational cohort study in 1210 patients from the Collaborative Islet Transplant Registry. Lancet Diabetes Endocrinol. 2023 Jun;11(6):391-401. doi: 10.1016/S2213-8587(23)00082-7. Epub 2023 Apr 24.
- Maanaoui M, Chetboun M, Top I, Elsermans V, Kerr-Conte J, Le Mapihan K, Defrance F, Gmyr V, Hubert T, Labalette M, Hazzan M, Vantyghem MC, Pattou F. The challenge of HLA donor specific antibodies in the management of pancreatic islet transplantation: an illustrative case-series. Sci Rep. 2022 Jul 21;12(1):12463. doi: 10.1038/s41598-022-16782-3.
- Wojtusciszyn A, Branchereau J, Esposito L, Badet L, Buron F, Chetboun M, Kessler L, Morelon E, Berney T, Pattou F, Benhamou PY, Vantyghem MC; TREPID group. Indications for islet or pancreatic transplantation: Statement of the TREPID working group on behalf of the Societe francophone du diabete (SFD), Societe francaise d'endocrinologie (SFE), Societe francophone de transplantation (SFT) and Societe francaise de nephrologie - dialyse - transplantation (SFNDT). Diabetes Metab. 2019 Jun;45(3):224-237. doi: 10.1016/j.diabet.2018.07.006. Epub 2018 Sep 14.
- Rickels MR, Stock PG, de Koning EJP, Piemonti L, Pratschke J, Alejandro R, Bellin MD, Berney T, Choudhary P, Johnson PR, Kandaswamy R, Kay TWH, Keymeulen B, Kudva YC, Latres E, Langer RM, Lehmann R, Ludwig B, Markmann JF, Marinac M, Odorico JS, Pattou F, Senior PA, Shaw JAM, Vantyghem MC, White S. 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. Transplantation. 2018 Sep;102(9):1479-1486. doi: 10.1097/TP.0000000000002158.
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Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
- 2025-06-290
- A111/2025-06-290/001 (Altro identificatore: Scientific and ethics committee of the Montpellier University Hospital)
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