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International Islet Transplant Registry (ITR) Newsletter #9, June 2001

International Islet Transplant Registry (ITR) Newsletter #9, June 2001. Mathias D. Brendel, Bernhard J. Hering, Andreas O. Schultz, Reinhard G. Bretzel. Third Medical Department, University Hospital Giessen, Germany. Longest Graft Function of Islet Allografts in Diabetes Mellitus .

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International Islet Transplant Registry (ITR) Newsletter #9, June 2001

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  1. International Islet Transplant Registry (ITR) Newsletter #9, June 2001 Mathias D. Brendel, Bernhard J. Hering, Andreas O. Schultz, Reinhard G. Bretzel Third Medical Department, University Hospital Giessen, Germany

  2. Longest Graft Functionof Islet Allografts in Diabetes Mellitus graft function insulin independence IAK > 11 yrs 1 mo 4 yrs 2 m SIK > 10 yrs 1 mo 5 yrs 10 m PIDM-Allo 4 yrs 8 m 4 yrs 8 m PIDM-Auto > 13 yrs > 13 yrs

  3. Summary of Adult Islet Autografts According to Institution and Year 1990 through December 31, 2000 2000 data on file incomplete

  4. Islet Autografts from 1990 - 2000 • Institutions Minneapolis 54 Leicester 34 Geneva 14 Indianapolis 1111 other Institutions 27 • No. of cases 140 • Insulin-independent ≥ 7 days (1990-2000): 41 / 64* (64%) • Insulin-independent at ≥ 1 yr (1990-1999 + one year follow-up): 27 / 57* (47%)if more than 300,000 IEQ transplanted: 15 / 21* (71%) • Longest insulin-independence follow-up after total pancreatectomy: > 13 yrs * only well documented cases 2000 data on file incomplete

  5. Summary of Adult Islet Allografts According to Institution and Year - 1990 through December 31, 2000 2000 data on file incomplete

  6. 15 15 15 14 14 12 12 12 11 11 10 9 8 5 5 4 4 2 2 2 2 2 2 2 1 1 1 1 0 No. of Institutions Reporting Adult Islet Allografts in Patients with Diabetes by Year from 1974 through 2000 1974 1980 1985 1990 1995 2000 No. of Institutions by Year 2000 data on file incomplete

  7. 59 60 51 50 44 38 37 40 34 29 28 30 26 25 22 20 14 12 11 10 10 9 10 6 4 4 3 2 2 2 1 0 No. of Adult Islet Allografts in Patients with Diabetes by Year from 1974 through 2000 1974 1980 1985 1990 1995 2000 No. of Adult Islet Allografts by Year 2000 data on file incomplete

  8. Summary of Adult Islet Allografts in Type-1 Diabetic RecipientsAccording to Institution and Year - 1990 through Dec. 31, 2000 2000 data on file incomplete

  9. Adult Islet Allografts in Type-1 Diabetic Recipients 1990 - 2000 • No. of cases: 355 • Institutions: Giessen 66 Milan 42 Minneapolis 35 Miami 32 Pittsburgh 26 Edmonton 20 Geneva 19 St. Louis 14 29 additional institutions (≤ 10 cases) 99 • Insulin-independent ≥ 7 days (1990-2000): 52 / 281 (19%)* • Insulin-independent at ≥ 1 yr (1990-1999 + one year follow-up): 27 / 237 (11%)* • Insulin-independent after 1:1 tx ≥ 7 days (1990-2000): 21 / 151 (14%)* • Insulin-independent after 1:1 tx at ≥ 1 yr (1990-1999+ one year follow-up): 13 / 140 ( 9%)* • Longest insulin-indepence follow-up: 70 months * only well documented cases

  10. total # of cases C-peptide ≥ 0.5 ng/mL at ≥ 1mo off insulin ≥ 1 week 200 169 133 150 108 (79%) 100 76 (70%) 34 50 23 (20%) (21%) 0 Europe North-America Insulin Independence and Basal C-Peptide after Adult Islet Allotransplantation in 281 Type-1 Diabetic Recipients from 1990 - 2000 according to Continent Four transplantations performed elsewhere

  11. total # of cases C-peptide ≥ 0.5 ng/mL at ≥ 1mo off insulin ≥ 1 week 160 140 140 120 97 95 100 78 80 (68%) 60 (80%) 40 20 18 20 (21%) (13%) 0 single donor multiple donors Insulin Independence and Basal C-Peptide One Year after Adult Islet Allotransplantationin 237* pre Tx C-Peptide negative Type-1 Diabetic Recipients from 1990 - 1999 according to Number of Donors * Only well documented cases

  12. total # of cases C-peptide ≥ 0.5 ng/mL at ≥ 1mo off insulin ≥ 1 week 146 160 140 114 120 (78%) 100 78 80 52 60 (67%) 32 40 (22%) 20 4 0 ≥ 6000 IEQ/kg BW < 6000 IEQ/kg BW Insulin Independence and Basal C-Peptide One Year after Adult Islet Allotransplantation in 237* pre Tx C-Peptide negative Type-1 Diabetic Recipients from 1990 - 1999 according to Number of Islet Equivalents per kg Body Weight (5%) * Only well documented cases no data available in 13 cases

  13. total # of cases C-peptide ≥ 0.5 ng/mL at ≥ 1mo off insulin ≥ 1 week 162 180 160 126 140 120 (78%) 100 62 80 60 38 28 40 (61%) 7 20 (17%) 0 ≤ 8 hrs > 8 hrs Insulin Independence and Basal C-Peptide One Year after Adult Islet Allotransplantation in 237* pre Tx C-Peptide negative Type-1 Diabetic Recipients from 1990 - 1999 according to Cold Ischemia Time (11%) no data available in 13 cases * Only well documented cases

  14. total # of cases C-peptide ≥ 0.5 ng/mL at ≥ 1mo off insulin ≥ 1 week 131 140 120 101 100 87 (77%) 80 59 60 (68%) 40 23 14 20 9 7 (26%) 3 5 5 3 1 0 0 (11%) 0 SIK IAK SIL ITA others Insulin Independence and Basal C-Peptide One Year after Adult Islet Allotransplantation in 237* pre Tx C-Peptide negative Type-1 Diabetic Recipients from 1990 - 1999 according to Recipient Category * Only well documented cases

  15. total # of cases C-peptide ≥ 0.5 ng/mL at ≥ 1mo off insulin ≥ 1 week 147 160 140 117 120 100 (80%) 80 60 40 30 31 40 20 15 18 15 20 (21%) 3 2 1 (67%) (45%) (100%) 0 ATG/ALG OKT3 Anti-IL-2R AB no T-cell AB Insulin Independence and Basal C-Peptide after One Year Adult Islet Allotransplantation in 237* pre Tx C-Peptide negative Type-1 Diabetic Recipients from 1990 - 1999 according to Induction Immunosuppression (10%) (5%) (7%) * Only well documented cases (Five additional cases with Anti-CD4 not depicted)

  16. total # of cases C-peptide ≥ 0.5 ng/mL at ≥ 1mo off insulin ≥ 1 week 170 180 160 140 115 120 (68%) 100 67 80 58 60 (87%) 40 21 17 20 (31%) (10%) 0 all four ≥ one not Insulin Independence and Basal C-Peptide One Year after Adult Islet Allotransplantation in 237* pre Tx C-Peptide negative Type-1 Diabetic Recipients from 1990 - 1999 according to Common Criteria Common Criteria: a) IEQ/kg BW ≥ 6,000; b) CIT ≤ 8 hrs; c) ALG/ATG; d) Implantation Site: Liver (via portal vein) * Only well documented cases

  17. Type-1 Diabetic Recipients of Adult Islet Allografts (One Year Follow-Up) Insulin-Independent Cases (n=50) through December 31, 1999 S=Steroids, C=Cyclosporine, T=Tacrolimus, Si=Sirolimus, D=Deoxyspergualin, A=Azathioprin, MMF=Mycophenolate Mofetil, aIL2R=Anti IL-2 Rec Ab, CPM=Cyclophosphamide, NA=Not Available Insulin independence for ≥ 7 days at any time after I-Tx

  18. Last but not Least (1) New website for the International Islet Transplant Registry at the University of Giessen, including the newest available version of the annual newsletter provided by the ITR, and valuable links to websites:http://www.med.uni-giessen.de/itr (2) Maintenance of the ITR will be supported by the JDFI for the coming five-year period

  19. We would like to thank all of the collaborating institutions for their continued support of the Islet Transplant Registry

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