ClinicalTrials.gg
RecruitingNCT03746769Updated Oct 15, 2026

Improving Islet Transplantation Outcomes With Gastrin for Type I Diabetes

A Phase 1/2 interventional study of Allogenic Human Islet Cells and Gastrin 17 in Diabetes Mellitus, Type 1, sponsored by City of Hope Medical Center. Recruiting at 1 site in United States. Open to participants aged 18 Years to 68 Years. Per ClinicalTrials.gov, last updated 2026-10-15.

Sponsored by City of Hope Medical Center · Phase 1/2, Interventional, and Treatment

From the registry’s dates

  • Started May 2019; still recruiting 7 years 5 months later.
Updated Oct 15, 2026Start date movedGo to Updates ↓
Phase
Phase 1/2
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
18 Years to 68 Years
Sex
All
01

Study summary

This clinical study will evaluate the safety and effectiveness of Gastrin treatment with islet transplantation to help patients with difficult to control type 1 diabetes make insulin again and improve blood sugar control.

This study involves two investigational (experimental) products not yet approved by the U.S. Food and Drug Administration (FDA) as a treatment for any disease:

  1. Human allogenic islet cells (islet cells from a deceased, unrelated human donor)
  2. Gastrin-17 (Gastrin) - a hormone secreted by the gut
Read the detailed description

Islet cell transplantation involves transplanting the cells that make insulin from a pancreas of deceased organ donor to a patient with diabetes. Because there is a limited supply of donor islet cells available, this study is testing whether Gastrin injections can help make a fewer number of transplanted islets work better.

Gastrin is a natural gut hormone that is present in the pancreas during its development in the embryo but not after birth, and is believed to participate in the formation of the normal pancreas. Several studies have tried to use gastrin to help grow insulin making islet cells in laboratory experiments or after transplanting islets in laboratory animals. In early clinical trials, diabetic patients treated with gastrin and other growth factors required less insulin after 4 weeks of gastrin treatment and the effect lasted more than 12 weeks after stopping treatment, suggesting that gastrin may have increased the number of cells that make insulin.

This study will evaluate whether taking Gastrin injections following a single islet transplantation is safe, improves how well the islet transplant works and/or helps increase the number of insulin-making cells in the islets.

Qualified participants will receive treatment with a single islet transplant and two rounds of gastrin treatment (twice daily injections for 30 days) with transplant and again 6 months later. Study participants will also take anti-rejection medications (to prevent the body from rejecting the islet cells) and other medications to guard against infection and support their health and/or the health of the transplanted islets. Participants will need to return to City of Hope in Duarte, CA for frequent follow-up visits for one year after transplant.

02

Conditions studied

  • Diabetes Mellitus, Type 1

Keywords

  • islet
  • islet cell
  • transplant
  • gastrin
  • hypoglycemia
  • labile diabetes
03

In context

Diabetes Mellitus, Type 1

3,754 studies on the registry are indexed under Diabetes Mellitus, Type 1; 600 are open to participants now.

This study's planned enrollment of 20 is below the median of 40 across 2,820 interventional studies indexed under Diabetes Mellitus, Type 1.

Browse Diabetes Mellitus, Type 1 studies →

Lead sponsor

City of Hope Medical Center is the lead sponsor of 677 studies on the registry; 181 are open to participants now.

Of its 31 completed or terminated interventional studies of FDA-regulated products, 12 (39%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 68 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age 18-68 years
  2. Type 1 diabetes mellitus (documented with fasting C-peptide level of \</= 0.2 ng/ml before and \</= 0.3 ng/ml after IV administration of 1 mg of glucagon) for at least 5 years.
  3. Unstable blood glucose characterized by:

    Frequent hypoglycemia (blood glucose less than or equal to 54 mg/dl more than once per week)

    -and/or- Hypoglycemia unawareness (Clarke score of 4 or more).

    -and/or- One or more severe hypoglycemic episodes in 12 months preceding enrollment

    -and/or- Erratic blood glucose levels that interfere with daily activities

    -and/or- One or more hospital visits for diabetic ketoacidosis in the 12 months preceding enrollment

  4. Ability and willingness to comply with post-transplant regimen, including , use of reliable , frequent clinic visits, testing and maintaining detailed logs of blood glucose levels, insulin doses and medications, and completing detailed follow-up studies.
  5. Ability to give .
  6. Fully vaccinated against COVID-19

Exclusion criteria

Exclusion Criteria:

  1. > 33
  2. Insulin requirements > 1.0 units/kg/day
  3. Significant kidney disease (estimated from serum creatinine measurement \<65 ml/min, random spot urine microalbumin to creatinine ratio >300mg albumin/g creatinine)
  4. Significant hepatobiliary disease, including elevation of liver enzymes > twice the for each of and AST (any elevation of these enzymes will be determined), not within normal limits, albumin \< 3.5 g/dl, liver masses, portal vein thrombosis, evidence of portal hypertension, or significant, untreated gallbladder disease (i.e. gallstones)
  5. Significant cardiovascular disease, including non-correctable coronary artery disease with \< 50% and/or recent myocardial infarction (within last 12 months); or extensive peripheral vascular disease not correctable by surgery,
  6. Evidence of active proliferative retinopathy
  7. Hypertension( >/= 140/90) despite appropriate treatment
  8. Hyperlipidemia (total cholesterol > 260 mg/dl, LDL > 160 mg/dl, and/or triglycerides > 300 mg/dl) despite appropriate treatment
  9. Anemia ( \< 11 g/dl) or other hematologic disorders that require medical attention
  10. WBC \<3,000/ul
  11. Increased risk of bleeding ( count \< 120,000 cells/ul; > 1.5), other chronic hemostasis disorders, or treatment with chronic anticoagulant therapy (i.e. heparin or warfarin)
  12. Recent unresolved acute infection (except for mild skin infection or nail fungal infection), or chronic infection, including tuberculosis, , , , CMV or syphilis (RPR)
  13. EBV IgG negative
  14. Any history of , except completely resected squamous or basal cell skin cancer or in situ cancer of the cervix
  15. Evidence of active peptic ulcer disease
  16. History of gastric bypass
  17. Recent history of non-adherence to recommended medical therapy
  18. Psychiatric illness that is untreated, or likely to interfere significantly with study compliance despite treatment
  19. Previous organ/tissue transplant
  20. Administration of within 60 days of enrollment.
  21. Presence of a chronic disease that must be chronically treated with medications
  22. Use of agents within four weeks of enrollment
  23. Active alcohol or substance abuse, including cigarette smoking (must be abstinent for > 3 months)
  24. Pregnant women, women intending future pregnancy, women of who are unable or unwilling to follow effective measures (i.e., tubal ligation, two barrier methods, abstinence) for the duration of study treatment and for as long as they are on medication, and women presently breastfeeding.
  25. Individuals without health insurance covering the cost of immunosuppression and clinical and laboratory follow-up after completion of the study
  26. Any medical condition that in the opinion of the investigator will interfere with safe participation in the trial
Terms in these criteria, in plain language(20)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
20 participants (estimated)

Study arms

  • Experimental
    Single Arm Study

    Biological: Allogenic Human Islet Cells · Drug: Gastrin 17

Interventions

  • BiologicalAllogenic Human Islet Cells

    islet cells transplanted into the portal vein in the liver

  • DrugGastrin 17

    Gastrin-17 (or GAST-17) - a gut hormone injected under the skin twice daily for 30 days soon after islet transplant and again 6 months later. Also, anti-rejection medications (to prevent the body from rejecting the islet cells) and other medications to guard against infection and support participant health and/or the health of the transplanted islets.

06

What researchers measure

Primary outcomes

  1. Proportion of subjects who are insulin independent, free from severe hypoglycemia and have HbA1c less than or equal to 6.5% ("complete response")

    Time frame: 1 year post transplant (6 months after second course of Gastrin)

Secondary outcomes

  1. Proportion of subjects who are free of severe hypoglycemic episodes (SHE) and have a HbA1c less than or equal to 7.0% ("partial response").

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

Other outcomes

  1. Reduction/elimination of hypoglycemia

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  2. Reduction in daily insulin use

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  3. Reduction of daily insulin use per 100,000 IEQ transplanted

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  4. C-peptide/insulin secretion response to glucose/arginine stimulation and other metabolic studies.

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  5. Incidence of treatment-related adverse events

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  6. Incidence of a change in immunosuppression drug regimen

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  7. The incidence of immune sensitization defined by presence of anti-HLA antibodies absent prior to transplant

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  8. Incidence of discontinuation of immunosuppression

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  9. Incidence of change or early discontinuation of Gastrin treatment

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  10. Incidence of change or early discontinuation of sitagliptin/esomeprazole supportive therapy

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  11. Improvement in glucose time in range during continuous glucose monitoring

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

  12. Improvement in Personal Glycemic State (PGS) score calculated from continuous glucose monitoring

    Time frame: At Month 1, Month 2.5, and Month 6 post start of each Gastrin course

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Orr C, Stratton J, El-Shahawy M, Forouhar E, Peng A, Singh G, Omori K, Qi M, Kandeel F. Impact of Tacrolimus, Sirolimus, Age, and Body Mass Index on the Occurrence of Skin Cancer and Islet Dysfunction After Transplantation. Cell Transplant. 2025 Jan-Dec;34:9636897241309412. doi: 10.1177/09636897241309412. PubMed 39780302 ↗
09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started May 2019 (actual). Primary completion is estimated for Aug 2028, 110 months after the start.

Of 44 phase 1/2 interventional studies under Diabetes Mellitus, Type 1, half reached primary completion within 57 months of starting (the median), counting those still running; a quarter within 31 and three quarters within 93. This study's planned 110 months is above that.

Start moved once since we started tracking on Sep 25, 2026: Jul 2019 → May 2019, on Oct 15, 2026.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Nov 9, 2018
First posted
Nov 20, 2018
StartActual
May 29, 2019was Jul 2019
Primary completionEst.
Aug 1, 2028
CompletionEst.
Aug 1, 2028
Last update
Oct 15, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Start date
Jul 7, 2019→May 29, 2019
Oct 15, 2026
Publications
1 publication citing this study linked from PubMed, e.g. PubMed 39780302 ↗
Oct 15, 2026
Show all 1 update
  1. Oct 15, 2026
    Publications 1 publication citing this study linked from PubMed, e.g. PubMed 39780302 ↗
    Start date Jul 7, 2019→May 29, 2019
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT03746769
Responsible party
Sponsor
First posted
Nov 20, 2018
Start date
May 29, 2019
Primary completion
Aug 1, 2028 (estimated)
Completion
Aug 1, 2028 (estimated)
Last update
Oct 15, 2026

Study contacts

Arthur Riggs Diabetes & Metabolism Research Institute at COH
Contact
Islets@coh.org
1-866-44-ISLET(1-866-444-7538)
Fouad Kandeel, MD, PhD
principal investigator · City of Hope Medical Center

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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