PMID- 23857001
OWN - NLM
STAT- MEDLINE
DCOM- 20130923
LR  - 20161125
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 96
IP  - 2
DP  - 2013 Jul 27
TI  - Predictive factors of allosensitization after immunosuppressant withdrawal in 
      recipients of long-term cultured islet cell grafts.
PG  - 162-9
LID - 10.1097/TP.0b013e3182977afc [doi]
AB  - BACKGROUND: Islet transplantation has been reported to induce allosensitization 
      in the majority of type 1 diabetic recipients of fresh or shortly incubated islet 
      grafts prepared from one to three donors. METHODS: We examined the appearance of 
      human leukocyte antigen (HLA) antibodies after withdrawal of immunosuppressants 
      in 35 type 1 diabetic recipients of islet cell grafts prepared from a median of 6 
      donors (range, 2-11), cultured for longer periods, and characterized for their 
      cellular composition. Immunosuppression consisted of antithymocyte globulin 
      induction followed by mycophenolate mofetil plus calcineurin inhibitors (n=28, 
      with 7 also receiving steroids) or sirolimus with (n=3) or without calcineurin 
      inhibitors (n=4). Both the complement-dependent cytotoxicity (CDC) assay (class 
      I) and the solid-phase flow-based Luminex method (class I and II) were used to 
      identify HLA antibodies. RESULTS: Immunosuppressant withdrawal resulted in CDC 
      positivity for class I antibodies in only 6% of patients. However, the majority 
      became positive for class I antibodies (72%) or class II antibodies (72%) in the 
      Luminex assay; positivity was not correlated to a higher number of donors or HLA 
      mismatches, but with a lower beta-cell purity; use of steroids reduced de novo 
      positivity for Luminex class I antibodies. CONCLUSION: Allosensitization to 
      cultured human islet cell grafts was low when assessed by CDC assay but high in 
      Luminex. No correlation was found with the number of donors but risk was higher 
      for grafts with lower beta-cell purity.
FAU - Hilbrands, Robert
AU  - Hilbrands R
AD  - Diabetes Research Center and Universitair Ziekenhuis Brussel, Vrije Universiteit 
      Brussel, Brussels, Belgium.
FAU - Gillard, Pieter
AU  - Gillard P
FAU - Van der Torren, Cornelis R
AU  - Van der Torren CR
FAU - Ling, Zhidong
AU  - Ling Z
FAU - Verheyden, Sonja
AU  - Verheyden S
FAU - Jacobs-Tulleneers-Thevissen, Daniel
AU  - Jacobs-Tulleneers-Thevissen D
FAU - Roep, Bart O
AU  - Roep BO
FAU - Claas, Frans H J
AU  - Claas FH
FAU - Demanet, Christian
AU  - Demanet C
FAU - Gorus, Frans K
AU  - Gorus FK
FAU - Pipeleers, Daniel
AU  - Pipeleers D
FAU - Keymeulen, Bart
AU  - Keymeulen B
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Antilymphocyte Serum)
RN  - 0 (Calcineurin Inhibitors)
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantibodies)
RN  - 0 (Isoantigens)
RN  - HU9DX48N0T (Mycophenolic Acid)
RN  - WM0HAQ4WNM (Tacrolimus)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Adult
MH  - Antilymphocyte Serum/immunology
MH  - Calcineurin Inhibitors
MH  - Cells, Cultured
MH  - Cytotoxicity Tests, Immunologic
MH  - Diabetes Mellitus, Type 1/epidemiology/immunology/*surgery
MH  - Female
MH  - Graft Rejection/*drug therapy/epidemiology
MH  - Graft Survival/immunology
MH  - Histocompatibility Antigens Class I/immunology
MH  - Humans
MH  - Immunosuppressive Agents/*administration & dosage/*adverse effects
MH  - Islets of Langerhans Transplantation/*immunology
MH  - Isoantibodies/blood/immunology
MH  - Isoantigens/immunology
MH  - Male
MH  - Methylprednisolone/administration & dosage/adverse effects
MH  - Middle Aged
MH  - Mycophenolic Acid/administration & dosage/adverse effects/analogs & derivatives
MH  - Predictive Value of Tests
MH  - Seroepidemiologic Studies
MH  - Substance Withdrawal Syndrome/*immunology
MH  - Tacrolimus/administration & dosage/adverse effects
EDAT- 2013/07/17 06:00
MHDA- 2013/09/24 06:00
CRDT- 2013/07/17 06:00
PHST- 2013/07/17 06:00 [entrez]
PHST- 2013/07/17 06:00 [pubmed]
PHST- 2013/09/24 06:00 [medline]
AID - 00007890-201307270-00009 [pii]
AID - 10.1097/TP.0b013e3182977afc [doi]
PST - ppublish
SO  - Transplantation. 2013 Jul 27;96(2):162-9. doi: 10.1097/TP.0b013e3182977afc.