| Recurrence of Type 1 Diabetes After Simultaneous Pancreas-Kidney Transplantation in the Absence of GAD and IA-2 Autoantibodies. | |
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MedLine Citation:
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PMID: 22151900 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We report herein the patterns of type 1 diabetes recurrence in a simultaneous pancreas-kidney transplant (SPK) recipient, in the absence of rejection. A 38-year-old female underwent SPK for end-stage nephropathy secondary to type 1 diabetes. Fasting blood glucose, HbA1c, fructosamine, C-peptide and autoantibodies (GAD-65, IA-2) were monitored throughout follow-up. At 3.5 years post-SPK, HbA1c and fructosamine increased sharply, indicating loss of perfect metabolic control, despite C-peptide levels in the normal-high range. Exogenous insulin was restarted 4 months later. C-peptide levels abruptly fell and became undetectable at 5.5 years. Autoantibody levels, which were undetectable at the time of SPK, never converted to positivity. Pancreas retranspantation was performed at 6 years. The failed pancreas graft had a normal macroscopic appearance. On histology, there were no signs of cellular or humoral rejection in the kidney or pancreas. A selective peri-islet lymphocytic infiltrate was observed, together with near-total destruction of β cells. At 2.5 years post retransplantation, pancreatic graft function is perfect. This observation indicates unequivocally that pancreas graft can be lost to recurrence of type 1 diabetes in the absence of rejection. GAD-65 and IA-2 autoantibodies are not reliable markers of autoimmunity recurrence. |
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Authors:
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M Assalino; M Genevay; P Morel; S Demuylder-Mischler; C Toso; T Berney |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-7 |
Journal Detail:
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Title: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons Volume: - ISSN: 1600-6143 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100968638 Medline TA: Am J Transplant Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 American Society of Transplantation and the American Society of Transplant Surgeons. |
Affiliation:
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Divisions of Transplantation and Visceral Surgery Department of Clinical Pathology, Geneva University Hospitals and University of Geneva, School of Medicine, Geneva, Switzerland. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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