Retrospective assessment of islet cell autoantibodies in pancreas organ donors.
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.


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.
Diabetes Research Institute, Leonard Miller School of Medicine, University of Miami, Miami, Florida, USA.
Stavros
S
Diamantopoulos
Gloria
G
Allende
Joseph M
JM
Ferreira
Gaetano
G
Ciancio
George W
GW
Burke
Alberto
A
Pugliese
D000017:ABO Blood-Group System; D001323:Autoantibodies / Q000097:blood*; D002102:Cadaver; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007330:Insulin Antibodies / Q000097:blood; D007515:Islets of Langerhans / Q000276:immunology*; D016030:Kidney Transplantation / Q000276:immunology; D016035:Pancreas Transplantation / Q000276:immunology*; D010180:Pancreatectomy; D012189:Retrospective Studies; D014019:Tissue Donors
D000017:ABO Blood-Group System; D001323:Autoantibodies; C096322:ICA512 autoantibody; D007330:Insulin Antibodies; D005968:Glutamate Decarboxylase