title: Cost and clinical outcome of islet transplantation in Norway 2010-2015.
abstract: Islet transplantation is a minimally invasive β-cell replacement strategy. Islet transplantation is a reimbursed treatment in Norway. Here, we summarize the cost and clinical outcome of 31 islet transplantations performed at Oslo University Hospital (OUS) from January 2010 to June 2015. Patients were retrospectively divided into three groups. Thirteen patients received either one or two islet transplantation alone (ITA), while five patients received islet transplantation after previous solid organ transplantation. For the group receiving 2 ITA, Kaplan-Meier estimates show an insulin independence of 20% more than 4 years after their last transplantation. An estimated 70% maintain at least partial graft function, defined as fasting C-peptide >0.1 nmol L-1, and 47% maintain a HbA1c below 6.5% or 2 percent points lower than before ITA. For all groups combined, we estimate that 44% of the patients have a 50% reduction in insulin requirement 4 years after the initial islet transplantation. The average cost for an islet transplantation procedure was 347 297±60 588 NOK, or 35 424±6182 EUR, of which isolation expenses represent 34%. We hereby add to the common pool of growing experience with islet transplantation and also describe the cost of the treatment at our center.
authors.affiliation: Department of Transplant Medicine, Cancer Institute, Oslo University Hospital, Oslo, Norway.|Institute for Surgical Research, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Simen W
authors.initials: SW
authors.lastname: Schive
authors.affiliation: Department of Transplant Medicine, Cancer Institute, Oslo University Hospital, Oslo, Norway.|Institute for Surgical Research, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Aksel
authors.initials: A
authors.lastname: Foss
authors.affiliation: Department of Transplant Medicine, Cancer Institute, Oslo University Hospital, Oslo, Norway.|Institute for Surgical Research, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Afaf
authors.initials: A
authors.lastname: Sahraoui
authors.affiliation: Department of Transplant Medicine, Cancer Institute, Oslo University Hospital, Oslo, Norway.|Institute for Surgical Research, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Kristine
authors.initials: K
authors.lastname: Kloster-Jensen
authors.affiliation: Department of Radiology, Cancer Institute, Oslo University Hospital, Oslo, Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Hafsahl
authors.affiliation: Department of Cell Therapy, Cancer Institute, Oslo University Hospital, Oslo, Norway.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Kvalheim
authors.affiliation: Division of Transplantation Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Lundgren
authors.affiliation: Department of Transplantation Surgery, University Hospital, Uppsala, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: von Zur-Mühlen
authors.affiliation: Department of Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Felldin
authors.affiliation: Department of Nephrology and Transplantation, University Hospital, Malmo, Sweden.
authors.forename: Ehab
authors.initials: E
authors.lastname: Rafael
authors.affiliation: Department of Surgery, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Lempinen
authors.affiliation: Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
authors.forename: Olle
authors.initials: O
authors.lastname: Korsgren
authors.affiliation: Department of Transplant Medicine, Cancer Institute, Oslo University Hospital, Oslo, Norway.|Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Trond G
authors.initials: TG
authors.lastname: Jenssen
authors.affiliation: Department of Finance and Resource Management Unit, Oslo University Hospital, Oslo, Norway.
authors.forename: Vinod
authors.initials: V
authors.lastname: Mishra
authors.affiliation: Department of Transplant Medicine, Cancer Institute, Oslo University Hospital, Oslo, Norway.|Institute for Surgical Research, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Hanne
authors.initials: H
authors.lastname: Scholz
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000191:economics* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000191:economics* / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D016381:Islets of Langerhans Transplantation / Q000191:economics* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011183:Postoperative Complications / Q000191:economics* / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: cost; islet transplantation; outcome; type 1 diabetes