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

P. B. Carroll, Camillo Ricordi, R. Shapiro, H. R. Rilo, P. Fontes, V. Scantlebury, W. Irish, A. G. Tzakis, T. E. Starzl

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)761-765
Number of pages5
JournalTransplantation
Volume55
Issue number4
StatePublished - May 5 1993
Externally publishedYes

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Islets of Langerhans Transplantation
Cell Transplantation
Islets of Langerhans
Kidney
Transplants
Pancreas Transplantation
Exocrine Pancreas
Graft Rejection
Graft Survival
Portal Vein
Kidney Transplantation
Immunosuppression
Cell Movement
Pancreas
Blood Cells
Survival Rate
Transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Carroll, P. B., Ricordi, C., Shapiro, R., Rilo, H. R., Fontes, P., Scantlebury, V., ... Starzl, T. E. (1993). Frequency of kidney rejection in diabetic patients undergoing simultaneous kidney and pancreatic islet cell transplantation. Transplantation, 55(4), 761-765.

Frequency of kidney rejection in diabetic patients undergoing simultaneous kidney and pancreatic islet cell transplantation. / Carroll, P. B.; Ricordi, Camillo; Shapiro, R.; Rilo, H. R.; Fontes, P.; Scantlebury, V.; Irish, W.; Tzakis, A. G.; Starzl, T. E.

In: Transplantation, Vol. 55, No. 4, 05.05.1993, p. 761-765.

Research output: Contribution to journalArticle

Carroll, PB, Ricordi, C, Shapiro, R, Rilo, HR, Fontes, P, Scantlebury, V, Irish, W, Tzakis, AG & Starzl, TE 1993, 'Frequency of kidney rejection in diabetic patients undergoing simultaneous kidney and pancreatic islet cell transplantation', Transplantation, vol. 55, no. 4, pp. 761-765.
Carroll, P. B. ; Ricordi, Camillo ; Shapiro, R. ; Rilo, H. R. ; Fontes, P. ; Scantlebury, V. ; Irish, W. ; Tzakis, A. G. ; Starzl, T. E. / Frequency of kidney rejection in diabetic patients undergoing simultaneous kidney and pancreatic islet cell transplantation. In: Transplantation. 1993 ; Vol. 55, No. 4. pp. 761-765.
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