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Updated: Jul 17, 2026
09:01
Intraportal Transplantation of Pancreatic Islets in Mouse Model
Published on: May 5, 2018
Changes in renal function after clinical islet transplantation: four-year observational study
P A Senior1, M Zeman, B W Paty
1Clinical Islet Transplant Program, University of Alberta, Edmonton AB, Canada. petersonsenior@ualberta.ca
Summary
Clinical islet transplantation (CIT) improved glycemic control in type 1 diabetes patients. However, it was associated with a decline in estimated glomerular filtration rate (eGFR) and increased albuminuria over four years.
Area of Science:
- Nephrology
- Endocrinology
- Immunology
Background:
- Diabetic nephropathy (DN) progression can be slowed by tight glycemic control.
- Pancreas transplantation may lead to histological regression of DN.
- The impact of clinical islet transplantation (CIT) and immunosuppression on renal function remains unclear.
Purpose of the Study:
- To evaluate the effects of CIT and immunosuppression on renal function in type 1 diabetes patients.
- To assess changes in estimated glomerular filtration rate (eGFR) and albuminuria post-CIT.
Main Methods:
- Retrospective analysis of 41 type 1 diabetes subjects post-CIT.
- Monitoring of renal function (eGFR) and albuminuria over a median of 29.8 months.
- Subjects received sirolimus and tacrolimus for immunosuppression.
Main Results:
- HbA(1c) significantly improved post-CIT and was sustained.
- A significant decline in eGFR was observed over 4 years (p = 0.0011).
- Progression of albuminuria occurred in most subjects, with variable eGFR decline rates.
Conclusions:
- CIT with sirolimus/tacrolimus is linked to declining eGFR and worsening albuminuria despite improved glycemic control.
- The rate of eGFR decline is highly variable and unpredictable.
- Prospective CIT candidates require thorough discussion regarding nephrotoxicity risks and risk:benefit ratio, especially those with pre-existing renal impairment.
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