National Institutes of Health–Sponsored Clinical Islet Transplantation Consortium Phase 3 Trial: Manufacture of a Complex Cellular Product at Eight Processing Facilities

Author:

Ricordi Camillo1,Goldstein Julia S.2,Balamurugan A.N.3,Szot Gregory L.4,Kin Tatsuya5,Liu Chengyang6,Czarniecki Christine W.2,Barbaro Barbara7,Bridges Nancy D.2,Cano Jose8,Clarke William R.9,Eggerman Thomas L.10,Hunsicker Lawrence G.9,Kaufman Dixon B.11,Khan Aisha1,Lafontant David-Erick9,Linetsky Elina1,Luo Xunrong11,Markmann James F.12,Naji Ali6,Korsgren Olle13,Oberholzer Jose7,Turgeon Nicole A.8,Brandhorst Daniel14,Chen Xiaojuan11,Friberg Andrew S.13,Lei Ji12,Wang Ling-jia11,Wilhelm Joshua J.3,Willits Jamie9,Zhang Xiaomin11,Hering Bernhard J.3,Posselt Andrew M.4,Stock Peter G.4,Shapiro A.M. James5

Affiliation:

1. Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL

2. National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD

3. Schulze Diabetes Institute and Department of Surgery, University of Minnesota, Minneapolis, MN

4. Department of Surgery, University of California, San Francisco, San Francisco, CA

5. Clinical Islet Transplant Program and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada

6. Institute for Diabetes, Obesity and Metabolism and Departments of Surgery and Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA

7. Division of Transplantation, University of Illinois Hospital and Health Sciences System, Chicago, IL

8. Division of Transplantation, Department of Surgery, Emory Transplant Center, Emory University, Atlanta, GA

9. Clinical Trials Statistical and Data Management Center, University of Iowa, Iowa City, IA

10. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD

11. Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL

12. Division of Transplant Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA

13. Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden

14. Department of Clinical Immunology, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden

Abstract

Eight manufacturing facilities participating in the National Institutes of Health–sponsored Clinical Islet Transplantation (CIT) Consortium jointly developed and implemented a harmonized process for the manufacture of allogeneic purified human pancreatic islet (PHPI) product evaluated in a phase 3 trial in subjects with type 1 diabetes. Manufacturing was controlled by a common master production batch record, standard operating procedures that included acceptance criteria for deceased donor organ pancreata and critical raw materials, PHPI product specifications, certificate of analysis, and test methods. The process was compliant with Current Good Manufacturing Practices and Current Good Tissue Practices. This report describes the manufacturing process for 75 PHPI clinical lots and summarizes the results, including lot release. The results demonstrate the feasibility of implementing a harmonized process at multiple facilities for the manufacture of a complex cellular product. The quality systems and regulatory and operational strategies developed by the CIT Consortium yielded product lots that met the prespecified characteristics of safety, purity, potency, and identity and were successfully transplanted into 48 subjects. No adverse events attributable to the product and no cases of primary nonfunction were observed.

Funder

National Institute of Allergy and Infectious Diseases

National Institute for Diabetes and Digestive and Kidney Diseases

General Clinical Research Center Awards and Clinical and Translational Science Awards

Publisher

American Diabetes Association

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

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