Optimizing primary graft function in islet allotransplantation: The Lille experience

Abstract Islet allotransplantation has been shown to be effective in restoring endogenous insulin secretion. Many initial reports showed, however, a sharp decline of islet graft function with time. In the late 1990s we hypothesized that islet transplantation success could be significantly prolonged by increasing islet primary graft function, through the deliberate repetition of islet infusions. We report here the favorable long-term outcome of this strategy in patients with type 1 diabetes and severe hypoglycemia unawareness or after a kidney graft with the Edmonton immunosuppressive regimen. Our results suggest that optimizing initial graft function is essential for the long-term success of beta cell replacement.