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Updated: Aug 17, 2026
A Method for Murine Islet Isolation and Subcapsular Kidney Transplantation
Published on: April 13, 2011
Islet transplantation is associated with an improvement of cardiovascular function in type 1 diabetic kidney
Paolo Fiorina1, Chiara Gremizzi, Paola Maffi
1Department of Medicine, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy. secchi.antonio@hsr.it
Insights
Islet transplantation improves cardiovascular function in type 1 diabetic patients with end-stage renal disease (ESRD). Patients receiving both kidney and islet transplants showed better cardiac parameters and reduced QT dispersion compared to those receiving only a kidney transplant.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Cardiovascular complications are a leading cause of mortality in type 1 diabetic patients with end-stage renal disease (ESRD).
- Kidney transplantation is a standard treatment for ESRD, but cardiovascular risks persist.
Purpose of the Study:
- To investigate the impact of islet transplantation on cardiovascular function in type 1 diabetic patients with ESRD who have already received a kidney transplant.
- To compare cardiovascular outcomes between patients receiving combined kidney-islet transplants versus kidney-only transplants.
Main Methods:
- A cohort of 42 type 1 diabetic patients with ESRD post-kidney transplant was studied.
- Seventeen patients received a functioning islet transplant (kidney-islet group), while 25 did not (kidney-only group).
- Cardiac function markers, including ejection fraction and filling rates, were assessed at baseline and 3 years post-transplantation.
Main Results:
- The kidney-islet group demonstrated significant improvements in ejection fraction and peak filling rate.
- QT dispersion and corrected QT (QTc) dispersion were reduced in the kidney-islet group.
- Markers of cardiac strain, such as natriuretic peptides, decreased in the kidney-islet group, while intima-media thickness stabilized.
Conclusions:
- Combined kidney and functioning islet transplantation significantly improves cardiovascular function in type 1 diabetic ESRD patients up to 3 years post-transplant.
- Islet transplantation offers a potential therapeutic strategy to mitigate cardiovascular risks in this high-risk population.
- The findings highlight the benefits of restoring endogenous insulin production via islet transplantation in managing cardiovascular health in diabetic kidney disease.
Objective:
Cardiovascular mortality and morbidity are major problems in type 1 diabetic patients with end-stage renal disease (ESRD). The aim of this study was to determine whether islet transplantation can improve cardiovascular function in these patients.
Research Design And Methods:
We assessed various markers of cardiac function at baseline and 3 years later in a population of 42 type 1 diabetic patients with ESRD who received a kidney transplant. Seventeen patients then received an islet transplant that had persistent function as defined by long-term C-peptide secretion (kidney-islet group). Twenty-five patients did not receive a functioning islet transplant (kidney-only group).
Results:
GHb levels were similar in the two groups, whereas the exogenous insulin requirement was lower in the kidney-islet group with persistent C-peptide secretion. Overall, cardiovascular parameters improved in the kidney-islet group, but not in the kidney-only group, with an improvement of ejection fraction (from 68.2 +/- 3.5% at baseline to 74.9 +/- 2.1% at 3 years posttransplantation, P < 0.05) and peak filling rate in end-diastolic volume (EDV) per second (from 3.87 +/- 0.25 to 4.20 +/- 0.37 EDV/s, P < 0.05). Time to peak filling rate remained stable in the kidney-islet group but worsened in the kidney-only group (P < 0.05). The kidney-islet group also showed a reduction of both QT dispersion (53.5 +/- 4.9 to 44.6 +/- 2.9 ms, P < 0.05) and corrected QT (QTc) dispersion (67.3 +/- 8.3 to 57.2 +/- 4.6 ms, P < 0.05) with higher erythrocytes Na(+)-K(+)-ATPase activity. In the kidney-islet group only, both atrial natriuretic peptide and brain natriuretic peptide levels decreased during the follow-up, with a stabilization of intima-media thickness.
Conclusions:
Our study showed that type 1 diabetic ESRD patients receiving a kidney transplant and a functioning islet transplant showed an improvement of cardiovascular function for up to 3 years of follow-up compared with the kidney-only group, who experienced an early failure of the islet graft or did not receive an islet graft.
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01:26Kidney Transplant II: Surgical Procedure