Allogeneic Islet Transplantation for the Treatment of Type 1 Diabetes

Inclusion Criteria:

• Patients with type 1 diabetes

• 18 <Age <55 years

• Plasma C-peptide <0.2 ng/ml basal and stimulated glucagon

• Evolution of diabetes for more than 5 years

• Regular patient follow-up (> or equal to 2 visits per year from the samediabetologist)

• Patient who received the information and have given their consent in writing

• Absence of HIV, hepatitis B and hepatitis C, HTLV-1-2

• ABO compatibility with the donor

• Cross match negative

• Anti-HLA antibodies (class I and / or class II) detected by lymphocytotoxicity <20%

• PCR negative for the BK virus in the blood (so as not to amplify the BK virusreplication with the ATG).

• Accepting patients effective contraception during the study period For patients in group IA

• Glomerular filtration rate estimated by the MDRD> 50 ml/min/1.73m2

• No perception of hypoglycaemia (less than 0.54 mg/dl glucose) at least one valuedocumented in the two years preceding and/or

• Occurrence of at least one severe hypoglycemic episode (with a third required) andunexplained in the two years before and/or at least two episodes of ketoacidosis peryear

• Average HbA1c> 8.5% over two years, despite intensified treatment (basal pattern,bolus)

• For patients in the IAK

• functional renal graft for at least 1 year

• glomerular filtration rate> 50 ml/min/1.73 m2

• proteinuria <0.5 g/day

• Absence of acute rejection in renal previous 6 months

Exclusion Criteria:

• BMI > 28

• Need insulin > 1 U/kg per day

• Pregnancy, lactation

• Intention of childbearing for the two sexes

• Psychiatric Disorders

• Inability to communicate or cooperate with the investigator

• Lack of therapeutic compliance, including HbA1C > 12%

• Chronic liver disease

• Progressive heart disease myocardial infarction within 6 months prior to inclusion,unbalanced CHD)

• Proliferative retinopathy unstabilized

• History of cancer, whatever the date, except for basal or squamous cell skin cancersover 1 year.

• Systemic infection

• Chronic high risk of requiring corticosteroids

• Need for long-term corticosteroid, outside that specified in renal transplantation,the patients will be weaned before transplantation

• Anticoagulant vitamin K or antiplatelet treatments

• Disorders of hemostasis TP <60 % TCA > 1.5 times the control

• Anti-HLA antibodies ( class I and/or class II ) detected by lymphocytotoxicity > 20%

• Platelets < 100 giga/L and/or neutrophils <1.5 giga/L

• Chronic intoxication by alcohol, tobacco, or other substance (abstinence > 6 monthsrequired)

• Active infection by hepatitis B, hepatitis C and HIV, HTLV-1-HTLV2

• Ascites