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Retrospective Assessment of Islet Cell Autoantibodies in Pancreas Organ Donors

¹ Diabetes Research Institute, Leonard Miller School of Medicine, University of Miami, Miami, Florida
² Department of Pediatrics, Division of Pediatric Endocrinology, Leonard Miller School of Medicine, University of Miami, Miami, Florida
³ Life Alliance Organ Recovery Agency, Leonard Miller School of Medicine, University of Miami, Miami, Florida
⁴ Department of Surgery, Division of Transplantation, Leonard Miller School of Medicine, University of Miami, Miami, Florida
⁵ Department of Medicine, Leonard Miller School of Medicine, University of Miami, Miami, Florida
⁶ Department of Microbiology and Immunology, Leonard Miller School of Medicine, University of Miami, Miami, Florida

Corresponding author: Alberto Pugliese, apuglies{at}med.miami.edu

OBJECTIVE—Of deceased pancreas donors, 3–4% may have autoantibodies (AAb) to pancreatic islet cell antigens; these autoantibodies are well-established markers of type 1 diabetes. We investigated whether donor AAb positivity could affect the outcome of pancreas transplantation.

RESEARCH DESIGN AND METHODS—We retrospectively tested AAb in 135 donors whose pancreata and kidneys were transplanted in type 1 diabetes patients. We measured AAb to glutamic acid decarboxylase (GAD-AAb), the tyrosine-phosphatase-like protein IA2 (IA2-AAb), and insulin (insulin-AAb). We then evaluated pancreas transplant outcome data.

RESULTS—Four of 135 (2.96%) donors were AAb positive: three donors had GAD-AAb, and one donor had insulin-AAb. Their respective recipients became insulin independent on follow-up. Three of the four recipients had normal, insulin-producing grafts 3–5.8 years after transplant. The recipient of the insulin-AAb–positive donor pancreas developed chronic rejection following discontinuation of immunosuppression 3.3 years after transplant.

CONCLUSIONS—Single AAb positivity did not affect the outcome of pancreas transplantation in our study.

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