Details

Autor(en) / Beteiligte

• Demeester, Simke
• Balke, Else M
• Van der Auwera, Bart J
• Gillard, Pieter
• Hilbrands, Robert
• Lee, DaHae
• Van de Velde, Ursule
• Ling, Zhidong
• Roep, Bart O
• Pipeleers, Daniel G
• Gorus, Frans K
• Keymeulen, Bart

Titel

HLA-A24 Carrier Status and Autoantibody Surges Posttransplantation Associate With Poor Functional Outcome in Recipients of an Islet Allograft

Ist Teil von

• Diabetes care, 2016-06, Vol.39 (6), p.1060-1064

Ort / Verlag

United States

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• We investigated whether changes in islet autoantibody profile and presence of HLA risk markers, reported to predict rapid β-cell loss in pre-type 1 diabetes, associate with poor functional outcome in islet allograft recipients. Forty-one patients received ≥2.3 million β-cells/kg body wt in one to two intraportal implantations. Outcome after 6-18 months was assessed by C-peptide (random and stimulated), insulin dose, and HbA1c. Patients carrying HLA-A*24-positive or experiencing a significant autoantibody surge within 6 months after the first transplantation (n = 19) had lower C-peptide levels (P ≤ 0.003) and higher insulin needs (P < 0.001) despite higher HbA1c levels (P ≤ 0.018). They became less often insulin independent (16% vs. 68%, P = 0.002) and remained less often C-peptide positive (47% vs. 100%, P < 0.001) than recipients lacking both risk factors. HLA-A*24 positivity or an autoantibody surge predicted insulin dependence (P = 0.007). HLA-A*24 and early autoantibody surge after islet implantation associate with poor functional graft outcome.