TY - JOUR
T1 - Early findings of prospective anti-HLA donor specific antibodies monitoring study in pancreas transplantation
T2 - Indiana University Health Experience
AU - Mujtaba, Muhammad A.
AU - Fridell, Jonathan A.
AU - Higgins, Nancy
AU - Sharfuddin, Asif A.
AU - Yaqub, Muhammad S.
AU - Kandula, Praveen
AU - Chen, Jeanne
AU - Mishler, Dennis P.
AU - Lobashevsky, Andrew
AU - Book, Benita
AU - Powelson, John
AU - Taber, Tim E.
PY - 2012/9
Y1 - 2012/9
N2 - The significance of donor-specific antibodies (DSA) is not well known in the setting of pancreas transplantation. Since December 2009, we prospectively followed pancreas transplant patients with single-antigen-luminex-bead testing at one, two, three, six, and then every six months for the first two yr. Thirty-five of the 92 patients that underwent pancreas transplantation (13 pancreas-alone [PTA], 20 with a kidney [SPK], and two after a kidney [PAK]) agreed to participate in study. Median age at transplant was 45 yr and follow-up was 23 months. Majority were Caucasian (n = 33) and male (n = 18). Rabbit anti-thymocyte globulin induction was used. Median HLA-mismatch was 4.2 ± 1.1. Eight patients (7SPK, 1PAK) developed post-transplant DSA at median follow-up of 76 d (26-119), 1 SPK had pre-formed DSA. Seven patients had both class I and class II DSA, one with class I and one with class II only. Mean peak class I DSA-MFI was 3529 (±1456); class II DSA-MFI was 5734 (±3204) whereas cumulative DSA MFI (CI + CII) was 9264 (±4233). No difference was observed in the patient and donor demographics among patients with and without DSA. One patient in non-DSA group developed acute cellular rejection of pancreas. From our data it appears that post-transplant DSA in pancreas allograft recipients may not impact the early-pancreatic allograft outcomes. The utility of prospective DSA monitoring in pancreatic transplant patients needs further evaluation and long-term follow-up.
AB - The significance of donor-specific antibodies (DSA) is not well known in the setting of pancreas transplantation. Since December 2009, we prospectively followed pancreas transplant patients with single-antigen-luminex-bead testing at one, two, three, six, and then every six months for the first two yr. Thirty-five of the 92 patients that underwent pancreas transplantation (13 pancreas-alone [PTA], 20 with a kidney [SPK], and two after a kidney [PAK]) agreed to participate in study. Median age at transplant was 45 yr and follow-up was 23 months. Majority were Caucasian (n = 33) and male (n = 18). Rabbit anti-thymocyte globulin induction was used. Median HLA-mismatch was 4.2 ± 1.1. Eight patients (7SPK, 1PAK) developed post-transplant DSA at median follow-up of 76 d (26-119), 1 SPK had pre-formed DSA. Seven patients had both class I and class II DSA, one with class I and one with class II only. Mean peak class I DSA-MFI was 3529 (±1456); class II DSA-MFI was 5734 (±3204) whereas cumulative DSA MFI (CI + CII) was 9264 (±4233). No difference was observed in the patient and donor demographics among patients with and without DSA. One patient in non-DSA group developed acute cellular rejection of pancreas. From our data it appears that post-transplant DSA in pancreas allograft recipients may not impact the early-pancreatic allograft outcomes. The utility of prospective DSA monitoring in pancreatic transplant patients needs further evaluation and long-term follow-up.
KW - Antibody mediated rejection
KW - Donor-specific antibodies
KW - Pancreas survival
KW - Pancreas transplant
UR - https://www.scopus.com/pages/publications/84867629389
UR - https://www.scopus.com/pages/publications/84867629389#tab=citedBy
U2 - 10.1111/ctr.12005
DO - 10.1111/ctr.12005
M3 - Article
C2 - 22938159
AN - SCOPUS:84867629389
SN - 0902-0063
VL - 26
SP - E492-E499
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 5
ER -