Islet transplantation stabilizes hemostatic abnormalities and cerebral metabolism in individuals with type 1 diabetes

Objective: Islet after kidney transplantation has been shown to positively affect the quality of life for individuals with type 1 diabetes (T1D) by reducing the burden of diabetic complications, but fewer data are available for Islet transplantation alone (ITA). The aim of this study was to assess whether ITA has a positive impact on hemostatic and cerebral abnormalities in individuals with T1D.Research Design and Methods: Pro-thrombotic factors, platelet function/ultrastructure, cerebral morphology, metabolism and function have been investigated over a 15-month follow-up period, with ELISA/electron microscopy and magnetic resonance imaging, nuclear magnetic resonance spectroscopy (1H-MRS) and neuropsychological evaluation (POMS and PASAT tests), in 22 individuals with T1D who underwent islet transplantation alone (n=12) or remained on the waiting list (n=10). Patients were homogeneous at the time of enrolment on the waiting list with regard to metabolic criteria, hemostatic parameters and cerebral morphology/metabolism/function. Results: At 15 months follow-up, the Islet transplantation alone group, but not individuals with T1D remaining on the waiting list, showed: i) improved glucose metabolism; ii) near-normal platelet activation and pro-thrombotic factor levels; iii) near-normal cerebral metabolism and function; and iv) a near-normal neuropsychological test. Conclusion: Islet transplantation alone, despite immunosuppressive therapy, is associated with a near- normalization of hemostatic and cerebral abnormalities