PMID- 26227015
OWN - NLM
STAT- MEDLINE
DCOM- 20160927
LR  - 20230124
IS  - 1600-6143 (Electronic)
IS  - 1600-6135 (Linking)
VI  - 15
IP  - 12
DP  - 2015 Dec
TI  - De Novo Donor-Specific HLA Antibodies Are Associated With Rapid Loss of Graft 
      Function Following Islet Transplantation in Type 1 Diabetes.
PG  - 3239-46
LID - 10.1111/ajt.13407 [doi]
AB  - Outcomes after islet transplantation continue to improve but etiology of graft 
      failure remains unclear. De novo donor-specific human leukocyte antigen (HLA) 
      antibodies (DSA) posttransplant are increasingly recognized as a negative 
      prognostic marker. Specific temporal associations between DSA and graft function 
      remain undefined particularly in programs undertaking multiple sequential 
      transplants. Impact of de novo DSA on graft function over 12 months following 
      first islet transplant was determined prospectively in consecutive recipients 
      taking tacrolimus/mycophenolate immunosuppression at a single center. Mixed-meal 
      tolerance test was undertaken in parallel with HLA antibody assessment 
      pretransplant and 1-3 months posttransplant. Sixteen participants received a 
      total of 26 islet transplants. Five (19%) grafts were associated with de novo 
      DSA. Five (31%) recipients were affected: three post-first transplant; two 
      post-second transplant. DSA developed within 4 weeks of all sensitizing grafts 
      and were associated with decreased stimulated C-peptide (median [interquartile 
      range]) at 3 months posttransplant (DSA negative: 613(300-1090); DSA positive 
      106(34-235) pmol/L [p = 0.004]). De novo DSA directed against most recent islet 
      transplant were absolutely associated with loss of graft function despite 
      maintained immunosuppression at 12 months in the absence of a rescue 
      nonsensitizing transplant. Alemtuzumab induction immunosuppression was associated 
      with reduced incidence of de novo DSA formation (p = 0.03).
CI  - (c) Copyright 2015 The American Society of Transplantation and the American Society 
      of Transplant Surgeons.
FAU - Brooks, A M S
AU  - Brooks AM
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
FAU - Carter, V
AU  - Carter V
AD  - Histocompatibility and Immunogenetics Laboratory, National Health Service Blood 
      and Transplant, Newcastle upon Tyne, UK.
FAU - Liew, A
AU  - Liew A
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
FAU - Marshall, H
AU  - Marshall H
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
FAU - Aldibbiat, A
AU  - Aldibbiat A
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
FAU - Sheerin, N S
AU  - Sheerin NS
AD  - Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, UK.
FAU - Manas, D M
AU  - Manas DM
AD  - Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, UK.
FAU - White, S A
AU  - White SA
AD  - Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, UK.
FAU - Shaw, J A M
AU  - Shaw JA
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20150730
PL  - United States
TA  - Am J Transplant
JT  - American journal of transplantation : official journal of the American Society of 
      Transplantation and the American Society of Transplant Surgeons
JID - 100968638
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Diabetes Mellitus, Type 1/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/*epidemiology/etiology
MH  - Graft Survival
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Incidence
MH  - Islets of Langerhans Transplantation/*adverse effects
MH  - Isoantibodies/*blood/immunology
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - *Tissue Donors
OTO - NOTNLM
OT  - Antibody biology
OT  - clinical research/practice
OT  - islet isolation
OT  - islet transplantation
EDAT- 2015/08/01 06:00
MHDA- 2016/09/28 06:00
CRDT- 2015/08/01 06:00
PHST- 2014/12/07 00:00 [received]
PHST- 2015/04/03 00:00 [revised]
PHST- 2015/04/23 00:00 [accepted]
PHST- 2015/08/01 06:00 [entrez]
PHST- 2015/08/01 06:00 [pubmed]
PHST- 2016/09/28 06:00 [medline]
AID - S1600-6135(22)00489-0 [pii]
AID - 10.1111/ajt.13407 [doi]
PST - ppublish
SO  - Am J Transplant. 2015 Dec;15(12):3239-46. doi: 10.1111/ajt.13407. Epub 2015 Jul 
      30.