Risk Factors for Type 1 Diabetes Recurrence in Immunosuppressed Recipients of Simultaneous Pancreas-Kidney Transplants

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Francesco VendrameA Pugliese

Abstract

Patients with type 1 diabetes (T1D) who are recipients of pancreas transplants are believed to rarely develop T1D recurrence in the allograft if effectively immunosuppressed. We evaluated a cohort of 223 recipients of simultaneous pancreas-kidney allografts for T1D recurrence and its risk factors. With long-term follow-up, recurrence was observed in approximately 7% of patients. Comparing the therapeutic regimens employed in this cohort over time, lack of induction therapy was associated with recurrence, but this occurs even with the current regimen, which includes induction; there was no influence of maintenance regimens. Longitudinal testing for T1D-associated autoantibodies identified autoantibody positivity, number of autoantibodies, and autoantibody conversion after transplantation as critical risk factors. Autoantibodies to the zinc transporter 8 had the strongest and closest temporal association with recurrence, which was not explained by genetically encoded amino acid sequence donor-recipient mismatches for this autoantigen. Genetic risk factors included the presence of the T1D-predisposing HLA-DR3/DR4 genotype in the recipient and donor-recipient sharing of HLA-DR alleles, especially HLA-DR3. Thus, T1D recurrence is no...Continue Reading

Associated Clinical Trials

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Citations

Jun 11, 2016·Acta Diabetologica·E J SharplesP J Friend
Jan 28, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·E N RudolphE B Finger
Jul 7, 2018·Current Opinion in Organ Transplantation·Marcelo PerosaHuda Noujaim
Jun 28, 2016·Current Opinion in Organ Transplantation·George W BurkeAlberto Pugliese
Apr 21, 2018·Journal of Molecular Histology·Tianxue ZhaoWeiping Jia
Nov 10, 2015·Current Diabetes Reports·George W BurkeAlberto Pugliese
Jul 14, 2017·Clinical Diabetes and Endocrinology·Marcio W Lauria, Antonio Ribeiro-Oliveira
Jun 2, 2020·Anatomical Science International·Ahmed Othman Fathy Othman El-KershRasha H Al-Serwi
May 11, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Delphine KervellaDiego Cantarovich
Mar 19, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·Christophe MassetDiego Cantarovich
Jul 11, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Ugo BoggiThierry Berney

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Methods Mentioned

BETA
biopsy

Software Mentioned

GraphPad Prism
SAS

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