Ten Years of Preserved Kidney Function After Islet Transplant Graft Failure

Several studies in patients with type 1 diabetes have examined the impact of islet transplantation (ITx) on renal function (1–3). Our group and others (1,4) have reported the beneficial effect of ITx. Equally relevant, however, is the assessment of renal function in patients with graft failure (GF) who are exposed to the well-known potential toxicity from immunosuppressive drugs and risk of development or progression of diabetic nephropathy related to unstable glycemic control (5). In this study, we examined the renal function of 12 recipients of allogeneic ITx who developed GF (stimulated C-peptide <0.3 ng/mL) but had at least 1 year (range 1.0–5.1) of graft function. Maintenance immunosuppression consisted of sirolimus and tacrolimus, which were discontinued after GF. Patients were enrolled in the ongoing Long Term Surveillance of Islet Transplant Recipients Following Complete Graft Loss study at the University of Miami, 6.0 ± 1.8 years (range 2.9–8.8) after GF. In this interim report, we provide data on renal function for a mean of 10.7 years after islet GF (Fig. 1 A ). The estimated glomerular filtration rate (eGFR) at the end of follow-up was comparable to …