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Impact of Pancreatic Autoantibodies in Pancreas Graft Survival After Pancreas-Kidney Transplantation

2020Journal article Open access
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dc.contributor.authorPestana, Nicole
dc.contributor.authorMalheiro, Jorge
dc.contributor.authorSilva, Filipa
dc.contributor.authorSilva, Andreia
dc.contributor.authorRibeiro, Catarina
dc.contributor.authorPedroso, Sofia
dc.contributor.authorAlmeida, Manuela
dc.contributor.authorDias, Leonídio
dc.contributor.authorHenriques, António Castro
dc.contributor.authorMartins, La Salete
dc.date.accessioned2020-09-25T10:26:58Z
dc.date.available2020-09-25T10:26:58Z
dc.date.issued2020
dc.description.abstractIn simultaneous pancreas-kidney transplantation (SPKT), persistence or recurrence of pancreatic autoantibodies (PAs) has been associated with pancreas graft (PG) autoimmune-driven injury. Our aim was to analyze the impact of PAs on PG survival.Methods. Between January 1, 2000, and December 31, 2017, we studied 139 patients with post-SPKT antieglutamic acid decarboxylase (GAD) autoantibody. Alloimmune (ALI) events were defined as PG rejection and/or de novo donor-specific antibodies (DSA).Hence, 3 groups were defined: patients without ALI events or anti-GAD (n ¼ 42), those with ALI events (n ¼ 14), or those only with autoimmune events (positive for anti-GAD and no ALI events; n ¼ 83). Results. Male sex was predominant (n ¼ 72, 52%). Median age was 35 years (interquartile range: 31-39) and median follow-up was 6-7 years (interquartile range: 4.1-9.2). Regarding anti-GAD positivity post-SPKT (n ¼ 90, 65%), no differences were observed concerning age, sex, anti-HLA antibodies, HLA mismatch number and de novo DSA. ALI events were present in 10% (n ¼ 14). PG survival 15 years post-SPKT was better in patients without immune events (96%) followed by those with ALI (69%) and autoimmune events (63%) (P ¼ .025). Anti-GAD was associated to higher annualized mean Hb1AC (P ¼ .006) and lower mean C-peptide (P ¼ .013). According to pre- and post-SPKT anti-GAD status, conversion from negative to positive was associated to worse (63%) 10-year PG survival (P ¼ .044), compared to persistence of negative (100%) or positive anti-GAD (88%). Anti-islet cell and anti-insulin autoantibodies had no impact. Conclusion. Anti-GAD presence post-SPKT was associated to higher pâncreas disfunction and lower PG survival. De novo anti-GAD seems to offer a particular risk of PG failure.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationTransplantation Proceedings, 52, 1370e1375 (2020)pt_PT
dc.identifier.doi10.1016/j.transproceed.2020.02.035pt_PT
dc.identifier.issn0041-1345/20
dc.identifier.urihttp://hdl.handle.net/10400.26/33427
dc.language.isoengpt_PT
dc.publisherElsevierpt_PT
dc.subjectautoantibodies in Pancreaspt_PT
dc.subjectTransplantationpt_PT
dc.subjectPortugalpt_PT
dc.subjectPancreatic Autoantibodiespt_PT
dc.subjectMadeira Islandpt_PT
dc.subjectpancreas-kidney transplantationpt_PT
dc.subjectPG survivalpt_PT
dc.titleImpact of Pancreatic Autoantibodies in Pancreas Graft Survival After Pancreas-Kidney Transplantationpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1375pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage1370pt_PT
oaire.citation.titleTransplantation Proceedingspt_PT
oaire.citation.volume52pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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