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Frequency of kidney rejection in diabetic patients undergoing simultaneous kidney and pancreatic islet cell transplantation

Carroll, PB and Ricordi, C and Shapiro, R and Rilo, HR and Fontes, P and Scantlebury, V and Irish, W and Tzakis, AG and Starzl, TE (1993) Frequency of kidney rejection in diabetic patients undergoing simultaneous kidney and pancreatic islet cell transplantation. Transplantation, 55 (4). 761 - 765. ISSN 0041-1337

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An increased frequency of kidney rejection has been reported in diabetic patients who have simultaneous pancreas and kidney transplantation compared with patients who have a kidney transplant alone. Kidney graft outcome is similar in the two groups. The mechanism for increased kidney graft rejection with a simultaneous pancreas graft is not clear. It is ascribed to the immunogenicity of the exocrine pancreas that initiates migration of activated cells from the peripheral blood that are entrapped in the kidney. Since the volume of the transplanted tissue is less in islet transplantation (usually <2 ml) than in pancreas transplantation, one might not expect an increased frequency of kidney rejection in islet cell recipients. We looked at biopsy- proven kidney rejection episodes in patients who had combined kidney and islet transplants and compared this with the frequency of rejection in diabetic and nondiabetic patients who underwent a kidney transplant alone under the same immunosuppression. Diabetic patients who had kidney islet transplants (n=9) had a higher frequency of rejection (100%) compared with diabetic patients (n=107, 55.1%) and nondiabetic patients (n=327, 65%) who had a kidney transplant alone. The 1-year graft and patient survival rates were not different among the groups. Although the number of patients is small, it would appear that transplantation of a low volume of islet cells with high purity can lead to an increased frequency of kidney rejection. This is unlikely to be explained solely on the basis of fewer antigen matches in these recipients but may reflect the inherent immunogenicity of the purified islet preparations. Alternatively, there may be an effect of their direct infusion into the portal vein.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Carroll, PB
Ricordi, C
Shapiro, R
Rilo, HR
Fontes, P
Scantlebury, V
Irish, W
Tzakis, AG
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1993
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 55
Number: 4
Page Range: 761 - 765
DOI or Unique Handle: 10.1097/00007890-199304000-00015
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062112002, Starzl CV No. 1406
Date Deposited: 08 Apr 2010 17:23
Last Modified: 02 Feb 2019 13:56


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