Impact of Pancreatic Autoantibodies in Pancreas Graft Survival After Pancreas-Kidney Transplantation
| العنوان: | Impact of Pancreatic Autoantibodies in Pancreas Graft Survival After Pancreas-Kidney Transplantation |
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| المؤلفون: | Manuela Guedes de Almeida, Filipa V.M. Silva, La Salete Martins, Leonídio Dias, António Castro Henriques, Sofia Pedroso, Jorge Malheiro, Catarina Ribeiro, Nicole Pestana, Andreia Silva |
| المصدر: | Repositório Científico de Acesso Aberto de Portugal Repositório Científico de Acesso Aberto de Portugal (RCAAP) instacron:RCAAP |
| بيانات النشر: | Elsevier BV, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Graft Rejection, Male, medicine.medical_specialty, medicine.medical_treatment, Pancreas transplantation, Autoantigens, Gastroenterology, Pancreatic Autoantibodies, Interquartile range, Diabetes mellitus, Internal medicine, Humans, Medicine, Kidney transplantation, Autoantibodies, pancreas-kidney transplantation, Transplantation, Portugal, biology, Glutamate Decarboxylase, business.industry, Graft Survival, Autoantibody, Middle Aged, Madeira Island, medicine.disease, Kidney Transplantation, autoantibodies in Pancreas, PG survival, Diabetes Mellitus, Type 1, medicine.anatomical_structure, biology.protein, Female, Surgery, Pancreas Transplantation, Antibody, business, Pancreas |
| الوصف: | In 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. info:eu-repo/semantics/publishedVersion |
| تدمد: | 0041-1345 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b311b516da9502f569e9412e17aef3aeTest https://doi.org/10.1016/j.transproceed.2020.02.035Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b311b516da9502f569e9412e17aef3ae |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00411345 |
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