Improvement of Electrophysiological Neuropathy After Islet Transplantation for Type 1 Diabetes: A 5-Year Prospective Study

The consequences of islet transplantation (IT) on neuropathy remain unclear, especially since neurotoxic effects of tacrolimus have been reported (1). The restoration of a euglycemic state in the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications study and through alone or combined whole pancreas transplantation has been shown to halt the progression of diabetic neuropathy (2). A significant improvement of a nerve conduction velocity (NCV) score compared with baseline was observed after IT-after-kidney (IAK), without any difference from a control group of nine kidney-only transplanted patients (3). No significant improvement of NCV was noticed 3 years after IT-alone (ITA) in a crossover study compared with intensive medical therapy (4). There has been no study of cardiac autonomic neuropathy (CAN) after IT and the results after kidney-pancreas transplantation are discordant. The aim of our study is to describe the evolution of neuropathy after IT. This single-arm, 5-year prospective, longitudinal study included 21 type 1 diabetic patients who underwent IT (13 ITA, 8 IAK) in a single center. Immunosuppression was induced by interleukin-2 receptor antibodies and maintained with tacrolimus and sirolimus as described (5). The main study end …