A significant role for histocompatibility in human islet transplantation.

Abstract:

BACKGROUND:In recent years, transplantation of islets and pancreas has become a viable option for patients debilitated with type I diabetes. The success of islet transplantation has been attributed to the ability to isolate high quality islets for transplantation and capacity to maintain the recipient's immunosuppressive levels within a specific target range following transplantation. The purpose of this study was to determine the role of pretransplant sensitization to human leukocyte antigen (HLA) in islet transplantation. METHODS:We retrospectively analyzed seven patients that were transplanted with islets under the auspices of the Juvenile Diabetes Research Foundation and Islet Cell Resource Center/National Institutes of Health. Humoral sensitization towards donor antigens both prior to and following islet transplantation was detected by FLOW panel reactive antibodies (PRA) and donor-specific cellular sensitization was detected by performing enzyme-linked immunospot assay analysis for cytokines interferon-gamma and interleukin-2. RESULTS:Our analysis demonstrates that humoral and cellular sensitization to histocompatibility antigens prior to and after islet transplantation are associated with the failure of transplanted islets CONCLUSION:Patient selection based on sensitization to donor HLA may be one of the factors crucial for the success of islet transplant. Further, in some patients, rejection of islets can be associated with sensitization to mismatched donor histocompatibility antigens.

journal_name

Transplantation

journal_title

Transplantation

authors

Mohanakumar T,Narayanan K,Desai N,Ramachandran S,Shenoy S,Jendrisak M,Susskind BM,Olack B,Benshoff N,Phelan DL,Brennan DC,Fernandez LA,Odorico JS,Polonsky KS

doi

10.1097/01.tp.0000226161.82581.b2

subject

Has Abstract

pub_date

2006-07-27 00:00:00

pages

180-7

issue

2

eissn

0041-1337

issn

1534-6080

pii

00007890-200607270-00009

journal_volume

82

pub_type

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