New Trial Opens Islet Transplants to People with Type 1 Diabetes and Kidney Disease

A new clinical trial, funded by Breakthrough T1D and led by Eledon Pharmaceuticals, has just enrolled its first participant. The trial is testing tegoprubart, a targeted immunotherapy, combined with deceased-donor islet cell transplants in people who have type 1 diabetes and chronic kidney disease (CKD).

This marks a significant shift in access. Until now, people with type 1 diabetes and reduced kidney function have been excluded from islet transplant trials. The reason: standard immunosuppressant medications—particularly tacrolimus—can damage the kidneys and harm the transplanted islet cells themselves, making them unsuitable for people whose kidney function is already compromised.

Immunosuppression is essential after any transplant to prevent the body's immune system from rejecting the new tissue. But the medications traditionally used for this purpose come with significant side effects, especially for people with existing kidney disease.

Tegoprubart works differently. As a targeted immune therapy, it aims to prevent islet rejection while causing fewer of the toxic effects associated with standard immunosuppressants. This more targeted approach could make islet transplants a viable option for people previously considered ineligible due to their kidney status.

Eledon is currently running a separate Breakthrough T1D-funded trial testing tegoprubart with islet transplants in people with type 1 diabetes who experience severe low blood sugar events or hypoglycemia unawareness. The results so far are promising: all 12 enrolled participants have stopped requiring injected insulin, with no reported side effects. Three additional people have also been enrolled in this ongoing trial.

These early findings suggest that islet cell transplantation with tegoprubart immunosuppression can work toward making type 1 diabetes manageable without daily insulin injections. The new trial now aims to demonstrate whether this approach can safely extend to people managing both type 1 diabetes and chronic kidney disease.

Islet cell transplantation has long been considered a potential functional treatment for type 1 diabetes in people with severe, difficult-to-manage low blood sugar events. However, eligibility has been limited by the side effects of standard immunosuppressive drugs. Expanding the field to include people with reduced kidney function could open the door to islet transplants for a group that has been excluded from this option.

The launch of this trial reflects growing recognition that improving immunosuppression is key to broadening access to islet transplantation. As tegoprubart is tested in more populations, researchers hope to refine what works for different groups and reduce barriers to this treatment approach.

Origin: breakthrought1d.org (News report). Evidence: News report — unverified, pending corroboration. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.