title: HLA-A*24 Carrier Status and Autoantibody Surges Posttransplantation Associate With Poor Functional Outcome in Recipients of an Islet Allograft.
abstract: We investigated whether changes in islet autoantibody profile and presence of HLA risk markers, reported to predict rapid β-cell loss in pre-type 1 diabetes, associate with poor functional outcome in islet allograft recipients.
  
  
  
  Forty-one patients received ≥2.3 million β-cells/kg body wt in one to two intraportal implantations. Outcome after 6-18 months was assessed by C-peptide (random and stimulated), insulin dose, and HbA1c.
  
  
  
  Patients carrying HLA-A*24-positive or experiencing a significant autoantibody surge within 6 months after the first transplantation (n = 19) had lower C-peptide levels (P ≤ 0.003) and higher insulin needs (P < 0.001) despite higher HbA1c levels (P ≤ 0.018). They became less often insulin independent (16% vs. 68%, P = 0.002) and remained less often C-peptide positive (47% vs. 100%, P < 0.001) than recipients lacking both risk factors. HLA-A*24 positivity or an autoantibody surge predicted insulin dependence (P = 0.007).
  
  
  
  HLA-A*24 and early autoantibody surge after islet implantation associate with poor functional graft outcome.
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium simke.demeester@uzbrussel.be.
authors.forename: Simke
authors.initials: S
authors.lastname: Demeester
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium.
authors.forename: Else M
authors.initials: EM
authors.lastname: Balke
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium.
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Van der Auwera
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Gillard
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium.
authors.forename: Robert
authors.initials: R
authors.lastname: Hilbrands
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: DaHae
authors.initials: D
authors.lastname: Lee
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium.
authors.forename: Ursule
authors.initials: U
authors.lastname: Van de Velde
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium.
authors.forename: Zhidong
authors.initials: Z
authors.lastname: Ling
authors.affiliation: Department of Immunohaematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Bart O
authors.initials: BO
authors.lastname: Roep
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Pipeleers
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium.
authors.forename: Frans K
authors.initials: FK
authors.lastname: Gorus
authors.affiliation: Diabetes Research Center, Brussels Free University, Brussels, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Keymeulen
mesh_terms: D000328:Adult; D064591:Allografts; D001323:Autoantibodies / Q000276:immunology*; D002096:C-Peptide / Q000378:metabolism; D027682:Cation Transport Proteins / Q000276:immunology; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics / Q000276:immunology / Q000628:therapy*; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D059871:HLA-A24 Antigen / Q000235:genetics*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D050417:Insulin-Secreting Cells; D016381:Islets of Langerhans Transplantation; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D000075703:Zinc Transporter 8
chemical_list: D001323:Autoantibodies; D002096:C-Peptide; D027682:Cation Transport Proteins; D059871:HLA-A24 Antigen; D007004:Hypoglycemic Agents; C096322:ICA512 autoantibody; D007328:Insulin; C492522:SLC30A8 protein, human; D000075703:Zinc Transporter 8; D005968:Glutamate Decarboxylase