Toulouse Hospital Pioneers First-in-the-Nation Simultaneous Kidney-Islet Transplant from Maastricht 3 Donor

In a landmark achievement, a team at the University Hospital of Toulouse (CHU de Toulouse) in France has successfully performed a simultaneous kidney and islet transplantation using organs from a Maastricht 3 donor. This innovative procedure, completed on March 9, 2026, represents a national first and offers new hope for patients with type 1 diabetes and kidney failure.

What is a Maastricht 3 Donor?

The donor was classified as “Maastricht 3,” meaning they died after cardiac arrest following a decision to withdraw life support. Utilizing organs from Maastricht 3 donors is complex due to the specific challenges in organ preservation and function. This successful transplant demonstrates a significant advancement in overcoming these hurdles.

The Patient’s Condition and the Innovative Approach

The recipient suffered from type 1 diabetes complicated by end-stage renal disease, requiring years of dialysis. Due to major vascular constraints, a combined kidney-pancreas transplant was not feasible. The medical team opted for a combined approach: a kidney transplant to eliminate the need for dialysis and an islet transplant to improve blood sugar control and protect the newly transplanted kidney from diabetes-related damage.

How the Procedure Was Performed

The pancreas was sent to the Montpellier University Hospital for isolation of the islets of Langerhans – the insulin-producing cells. The kidney transplant was performed at Rangueil hospital in Toulouse. The islets were then injected into the patient’s liver via interventional radiology, coordinated by the nephrology and diabetology teams.

Positive Outcomes and Future Implications

Following the transplant, the patient no longer requires dialysis and is producing some of their own insulin, reducing the need for injections and stabilizing blood glucose levels. This breakthrough paves the way for wider application of this technique, potentially benefiting numerous patients with similar conditions.

Islet Transplantation: A Promising Treatment for Type 1 Diabetes

Islet transplantation has shown promise as a treatment for type 1 diabetes, but challenges remain. Successful engraftment of transplanted islets depends on rapid revascularization, and researchers are exploring alternative transplantation sites and methods to improve islet survival. Current clinical islet transplantation is often performed via the portal vein, but alternative sites are being investigated.

Types of Islet Transplantation

Allogeneic islet transplantation can be performed in several ways: as Islet Transplant Alone (ITA) for non-uremic subjects, or as Simultaneous Islet-Kidney (SIK) or Islet-After-Kidney (IAK) transplantation in patients with end-stage renal disease. It can as well be part of multi-organ procedures.

Ongoing Research and Improvements

Research continues to focus on enhancing the success of islet transplantation, including developing new scaffold platforms to promote vascularization and improve islet function. A study analyzing data from France between 2000 and 2017, involving 47 kidney transplant recipients who also received islet transplantation, demonstrated the potential for long-term benefits.