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Early findings of prospective anti‐ HLA donor specific antibodies monitoring study in pancreas transplantation: I ndiana U niversity H ealth E xperience
Author(s) -
Mujtaba Muhammad A.,
Fridell Jonathan A.,
Higgins Nancy,
Sharfuddin Asif A.,
Yaqub Muhammad S.,
Kandula Praveen,
Chen Jeanne,
Mishler Dennis P.,
Lobashevsky Andrew,
Book Benita,
Powelson John,
Taber Tim E.
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12005
Subject(s) - medicine , pancreas transplantation , transplantation , pancreas , prospective cohort study , kidney transplantation , surgery , demographics , immunosuppression , urology , gastroenterology , demography , sociology
The significance of donor‐specific antibodies ( DSA ) is not well known in the setting of pancreas transplantation. Since D ecember 2009, we prospectively followed pancreas transplant patients with single‐antigen‐luminex‐bead testing at one, two, three, six, and then every six months for the first two yr. Thirty‐five of the 92 patients that underwent pancreas transplantation (13 pancreas‐alone [ PTA ], 20 with a kidney [ SPK ], and two after a kidney [ PAK ]) agreed to participate in study. Median age at transplant was 45 yr and follow‐up was 23 months. Majority were C aucasian (n = 33) and male (n = 18). Rabbit anti‐thymocyte globulin induction was used. Median HLA ‐mismatch was 4.2 ± 1.1. Eight patients (7 SPK , 1 PAK ) developed post‐transplant DSA at median follow‐up of 76 d (26–119), 1 SPK had pre‐formed DSA . Seven patients had both class I and class II DSA , one with class I and one with class II only. Mean peak class I DSA ‐ MFI was 3529 (±1456); class II DSA ‐ MFI was 5734 (±3204) whereas cumulative DSA MFI ( CI + CII ) was 9264 (±4233). No difference was observed in the patient and donor demographics among patients with and without DSA . One patient in non‐ DSA group developed acute cellular rejection of pancreas. From our data it appears that post‐transplant DSA in pancreas allograft recipients may not impact the early‐pancreatic allograft outcomes. The utility of prospective DSA monitoring in pancreatic transplant patients needs further evaluation and long‐term follow‐up.