Retrospective Assessment of Islet Cell Autoantibodies in Pancreas Organ Donors
- Stavros Diamantopoulos, MD12,
- Gloria Allende, MS1,
- Joseph M. Ferreira3,
- Gaetano Ciancio, MD4,
- George W. Burke, MD14 and
- Alberto Pugliese, MD156
- 1Diabetes Research Institute, Leonard Miller School of Medicine, University of Miami, Miami, Florida
- 2Department of Pediatrics, Division of Pediatric Endocrinology, Leonard Miller School of Medicine, University of Miami, Miami, Florida
- 3Life Alliance Organ Recovery Agency, Leonard Miller School of Medicine, University of Miami, Miami, Florida
- 4Department of Surgery, Division of Transplantation, Leonard Miller School of Medicine, University of Miami, Miami, Florida
- 5Department of Medicine, Leonard Miller School of Medicine, University of Miami, Miami, Florida
- 6Department of Microbiology and Immunology, Leonard Miller School of Medicine, University of Miami, Miami, Florida
- Corresponding author: Alberto Pugliese, apuglies{at}med.miami.edu
Abstract
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.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 12 June 2008.
S.D. and G.A. contributed equally to this study.
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- Accepted June 4, 2008.
- Received April 3, 2008.
- DIABETES CARE
