PMID- 22080832
OWN - NLM
STAT- MEDLINE
DCOM- 20121101
LR  - 20211021
IS  - 1555-3892 (Electronic)
IS  - 0963-6897 (Print)
IS  - 0963-6897 (Linking)
VI  - 21
IP  - 5
DP  - 2012
TI  - HLA class I sensitization in islet transplant recipients: report from the 
      Collaborative Islet Transplant Registry.
PG  - 901-8
LID - 10.3727/096368911X612468 [doi]
AB  - Pancreatic islet transplantation is a promising treatment option for patients 
      severely affected with type 1 diabetes. This report from CITR presents pre- and 
      posttransplant human leukocyte antigen (HLA) class I sensitization rates in 
      islet-alone transplantation. Data came from 303 recipients transplanted with 
      islet-alone between January 1999 and December 2008. HLA class I sensitization was 
      determined by the presence of anti-HLA class I antibodies. Panel-reactive 
      antibodies (PRA) from prior to islet infusion and at 6 months, and yearly 
      posttransplant was correlated to measures of islet graft failure. The cumulative 
      number of mismatched HLA alleles increased with each additional islet infusion 
      from a median of 3 for one infusion to 9 for three infusions. Pretransplant PRA 
      was not predictive of islet graft failure. However, development of PRA >20% 
      posttransplant was associated with 3.6-fold (p < 0.001) increased hazard ratio 
      for graft failure. Patients with complete graft loss who had discontinued 
      immunosuppression had significantly higher rate of PRA >/= 20% compared to those 
      with functioning grafts who remained on immunosuppression. Exposure to repeat HLA 
      class I mismatch at second or third islet infusions resulted in less frequent 
      development of de novo HLA class I antibodies when compared to increased class I 
      mismatch. The development of HLA class I antibodies while on immunosuppression is 
      associated with subsequent islet graft failure. The risk of sensitization may be 
      reduced by minimizing the number of islet donors used per recipient, and in the 
      absence of donor-specific anti-HLA antibodies, repeating HLA class I mismatches 
      with subsequent islet infusions.
FAU - Naziruddin, Bashoo
AU  - Naziruddin B
AD  - Baylor Simmons Transplant Institute, Dallas, TX 75246, USA. 
      bashoon@baylorhealth.edu
FAU - Wease, Steve
AU  - Wease S
FAU - Stablein, Donald
AU  - Stablein D
FAU - Barton, Franca B
AU  - Barton FB
FAU - Berney, Thierry
AU  - Berney T
FAU - Rickels, Michael R
AU  - Rickels MR
FAU - Alejandro, Rodolfo
AU  - Alejandro R
LA  - eng
GR  - UC4 DK098086/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20111111
PL  - United States
TA  - Cell Transplant
JT  - Cell transplantation
JID - 9208854
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Alleles
MH  - Diabetes Mellitus, Type 1/therapy
MH  - Female
MH  - Graft Rejection/immunology
MH  - Histocompatibility Antigens Class I/immunology/*metabolism
MH  - Histocompatibility Testing
MH  - Humans
MH  - *Islets of Langerhans Transplantation
MH  - Isoantibodies/immunology
MH  - Male
MH  - Middle Aged
MH  - Registries
MH  - Transplantation, Homologous/immunology
PMC - PMC4396620
MID - NIHMS676788
COIS- All authors had no conflicts of interest on this study.
EDAT- 2011/11/15 06:00
MHDA- 2012/11/02 06:00
PMCR- 2015/04/14
CRDT- 2011/11/15 06:00
PHST- 2011/11/15 06:00 [entrez]
PHST- 2011/11/15 06:00 [pubmed]
PHST- 2012/11/02 06:00 [medline]
PHST- 2015/04/14 00:00 [pmc-release]
AID - ct0425naziruddin [pii]
AID - 10.3727/096368911X612468 [doi]
PST - ppublish
SO  - Cell Transplant. 2012;21(5):901-8. doi: 10.3727/096368911X612468. Epub 2011 Nov 
      11.