Evidence of recurrent autoimmunity in human allogeneic islet transplantation.
We transplanted 10,000 isolated, handpicked human pancreatic islets into the subfascial compartment of the forearm muscle of a type I diabetic recipient who had received a successful renal transplant one year prior. The recipient was maintained on his usual immunosuppressive therapy of cyclosporine, azathioprine, and prednisone. A biopsy performed 7 days after transplantation showed normal islets with both insulin- and glucagon-staining cells present and no lymphocytic infiltration. A second biopsy performed 14 days after transplantation showed a dense mononuclear cell infiltrate with a preferential loss of insulin-staining cells relative to glucagon-staining cells in the islets. These data are consistent with recurrent autoimmune diabetes in an isolated islet allograft in an immunosuppressed type I diabetic recipient. In addition, this forearm subfascial site may be a useful means to monitor islet rejection and autoimmune recurrence in therapeutic intraportal islet allografts.
Stegall
M D
MD
Department of Surgery, University of Colorado School of Medicine, Denver, CO 80262, USA.
Lafferty
K J
KJ
Kam
I
I
Gill
R G
RG
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000503:physiopathology* / Q000628:therapy; D005542:Forearm; D005934:Glucagon / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D007328:Insulin / Q000032:analysis; D007515:Islets of Langerhans / Q000378:metabolism / Q000473:pathology; D016381:Islets of Langerhans Transplantation; D008297:Male; D012008:Recurrence; D014184:Transplantation, Homologous
D007328:Insulin; D005934:Glucagon