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HLA-A*24 carrier status and autoantibody surges posttransplantation associate vith poor functional outcome in recipients of an islet allograft

Tijdschriftbijdrage - Tijdschriftartikel

OBJECTIVE: 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.

RESEARCH DESIGN AND METHODS: 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.

RESULTS: 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).

CONCLUSIONS: HLA-A*24 and early autoantibody surge after islet implantation associate with poor functional graft outcome.

Tijdschrift: Diabetes Care
ISSN: 0149-5992
Issue: 6
Volume: 39
Pagina's: 1060-1064
Aantal pagina's: 5
Jaar van publicatie:2016
  • Scopus Id: 84971254929
  • WoS Id: 000376980500035
  • DOI: https://doi.org/10.2337/dc15-2768
  • ORCID: /0000-0003-0228-699X/work/60677856
  • ORCID: /0000-0002-9007-6177/work/60767582
  • ORCID: /0000-0002-8671-4527/work/61349414
  • ORCID: /0000-0002-6440-2485/work/61423521
  • ORCID: /0000-0003-4133-2565/work/76767064
  • ORCID: /0000-0001-7179-1717/work/83057858