Langetermijnoverleving na bètaceltransplantatie bij patiënten met diabetes mellitus type 1 in België: een overzicht en retrospectieve studie

Abstract

Long-term survival after beta cell transplantation in patients with diabetes mellitus type 1 in Belgium: a review and retrospective study Diabetes mellitus type 1 (DM1) is a condition associated with loss of functional beta cell mass and the need for intensive insulin treatment. Despite the technological advances in recent decades (continuous glucose monitoring, insulin pumps), there are still patients who suffer from problematic hypoglycemia and severe glycemic variability. Beta cell transplantation may offer them a therapeutic solution. Belgium has several decades of experience with this therapy. Beta cell transplantation starts with the right choice of donors and the isolation of sufficient numbers of functional beta cells. Immunosuppressive therapy is necessary for the acceptance of the beta cells within the recipient’s body and requires close monitoring. Approximately 60% of the patients who have received at least 2 transplants of 2 million beta cells per kg, have a successful clinical transplant function 1 year after transplantation. Patients below 40 years of age clearly do worse than older patients. Of the latter group, 1/5 still has an optimal transplant function and protection against hypoglycemia after 5 years. The number of transplanted beta cells is insufficient to permanently stop insulin. Adequate immunosuppression, the maximum functional beta cell mass achieved after transplantation and the age of the recipient at the time of the transplantation appear to be important factors. According to this study, beta cell transplantation remains a valid therapy for DM1 patients with problematic hypoglycemia and high glycemic variability.