Simke Demeester, Else M Balke, Bart J Van der Auwera, Pieter Gillard, Robert Hilbrands, DaHae Lee, Ursule Van de Velde, Zhidong Ling, Bart O Roep, Daniel G Pipeleers, Frans K Gorus, Bart Keymeulen
||Diabetes Care, 2016, Vol.39 (6)
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 HbA^sub 1c^. 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 HbA^sub 1c^ 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.