title: Low risk of anti-human leukocyte antigen antibody sensitization after combined kidney and islet transplantation.
abstract: Anti-human leukocyte antigen (HLA) antibody could lead to humoral rejection and a decrease in graft survival after kidney transplantation. A recent report has suggested that islet transplantation alone is associated with a high rate of sensitization. The withdrawal of the immunosuppressive therapy because of the progressive nonfunction of the islets could explain the high rate of sensitization. Because the specific risk of immunization of multiple islet infusions remains unknown, we studied the immunization rate in our cohort of multiple islet infusions transplant recipients. De novo anti-HLA antibodies were analyzed in 37 patients after islets alone (n=8), islet-after-kidney (n=13), and simultaneous islet-kidney (n=16) transplantation by solid phase assays over time. The rate of immunization was 10.8% that is comparable with the risk of immunization after kidney transplantation alone. Multiple islet infusions do not represent a specific risk for the development of anti-HLA antibodies after combined kidney-islets transplantation.
authors.affiliation: Transplantation Immunology Unit, Service of Immunology and Allergy and Service of Laboratory Medicine, Geneva University Hospital and Medical School, Geneva, Switzerland.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Ferrari-Lacraz
authors.forename: Thierry
authors.initials: T
authors.lastname: Berney
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Nicola
authors.initials: N
authors.lastname: Marangon
authors.forename: Karine
authors.initials: K
authors.lastname: Hadaya
authors.forename: Sandrine
authors.initials: S
authors.lastname: Demuylder-Mischler
authors.forename: Gilles
authors.initials: G
authors.lastname: Pongratz
authors.forename: Nadine
authors.initials: N
authors.lastname: Pernin
authors.forename: Jean
authors.initials: J
authors.lastname: Villard
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection; D006680:HLA Antigens / Q000737:chemistry / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007515:Islets of Langerhans / Q000473:pathology; D016381:Islets of Langerhans Transplantation / Q000295:instrumentation / Q000379:methods*; D016030:Kidney Transplantation / Q000276:immunology / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors
chemical_list: D006680:HLA Antigens; D007166:Immunosuppressive Agents