title: Early findings of prospective anti-HLA donor specific antibodies monitoring study in pancreas transplantation: Indiana University Health Experience.
abstract: 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.
authors.affiliation: Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA. mmujtaba@iupui.edu
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Mujtaba
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Fridell
authors.forename: Nancy
authors.initials: N
authors.lastname: Higgins
authors.forename: Asif A
authors.initials: AA
authors.lastname: Sharfuddin
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Yaqub
authors.forename: Praveen
authors.initials: P
authors.lastname: Kandula
authors.forename: Jeanne
authors.initials: J
authors.lastname: Chen
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Mishler
authors.forename: Andrew
authors.initials: A
authors.lastname: Lobashevsky
authors.forename: Benita
authors.initials: B
authors.lastname: Book
authors.forename: John
authors.initials: J
authors.lastname: Powelson
authors.forename: Tim E
authors.initials: TE
authors.lastname: Taber
mesh_terms: D000818:Animals; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood* / Q000276:immunology; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility; D006801:Humans; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic; D016035:Pancreas Transplantation / Q000276:immunology*; D011446:Prospective Studies; D011817:Rabbits; D012074:Remission Induction
chemical_list: D000961:Antilymphocyte Serum; D006680:HLA Antigens; D007518:Isoantibodies