HLA-B Matching Prolongs Allograft Survival in Islet Cell Transplantation
Islet cell transplantation (ITx) is an effective therapeutic approach for selected patients with type 1 diabetes with hypoglycemia unawareness and severe hypoglycemia events. In organ transplantation, human leukocyte antigen (HLA) mismatching between donor and recipient negatively impacts transplant...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-08-01
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| Series: | Cell Transplantation |
| Online Access: | https://doi.org/10.1177/09636897231166529 |
| _version_ | 1827888258155020288 |
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| author | Joana R. N. Lemos David A. Baidal Raffaella Poggioli Virginia Fuenmayor Carmen Chavez Ana Alvarez Camillo Ricordi Rodolfo Alejandro |
| author_facet | Joana R. N. Lemos David A. Baidal Raffaella Poggioli Virginia Fuenmayor Carmen Chavez Ana Alvarez Camillo Ricordi Rodolfo Alejandro |
| author_sort | Joana R. N. Lemos |
| collection | DOAJ |
| description | Islet cell transplantation (ITx) is an effective therapeutic approach for selected patients with type 1 diabetes with hypoglycemia unawareness and severe hypoglycemia events. In organ transplantation, human leukocyte antigen (HLA) mismatching between donor and recipient negatively impacts transplant outcomes. We aimed to determine whether HLA matching has an impact on islet allograft survival. Forty-eight patients were followed up after islet transplantation at our institution from 2000 to 2020 in a retrospective cohort. Patients underwent intrahepatic ITx or laparoscopic omental approach. Immunosuppression was dependent upon the protocol. We analyzed HLA data restricted to A, B, and DR loci on allograft survival using survival and subsequent multivariable analyses. Patients were aged 42.8 ± 8.4 years, and 64.3% were female. Diabetes duration was 28.6 ± 11.6 years. Patients matching all three HLA loci presented longer graft survival ( P = 0.030). Patients with ≥1 HLA-B matching had longer graft survival compared with zero matching ( P = 0.025). The number of HLA-B matching was positively associated with time of graft survival (Spearman’s rho = 0.590; P = 0.034). Analyses adjusted for confounders showed that ≥1 matching for HLA-B decreased the risk of allograft failure ( P = 0.009). Our data suggest that HLA-B matching between recipients and donors improved islet allograft survival. Matching all three HLA loci (A, B, and DR) was also associated with prolonged islet allograft survival. Prospective studies and a larger sample size are warranted to validate our findings. |
| first_indexed | 2024-03-12T20:32:10Z |
| format | Article |
| id | doaj.art-52bb053778b54afe96ac78350c4195cc |
| institution | Directory Open Access Journal |
| issn | 1555-3892 |
| language | English |
| last_indexed | 2024-03-12T20:32:10Z |
| publishDate | 2023-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Cell Transplantation |
| spelling | doaj.art-52bb053778b54afe96ac78350c4195cc2023-08-01T21:03:35ZengSAGE PublishingCell Transplantation1555-38922023-08-013210.1177/09636897231166529HLA-B Matching Prolongs Allograft Survival in Islet Cell TransplantationJoana R. N. Lemos0David A. Baidal1Raffaella Poggioli2Virginia Fuenmayor3Carmen Chavez4Ana Alvarez5Camillo Ricordi6Rodolfo Alejandro7Diabetes Research Institute (DRI) and Clinical Cell Transplant Program, Miller School of Medicine, University of Miami, Miami, FL, USADiabetes Research Institute (DRI) and Clinical Cell Transplant Program, Miller School of Medicine, University of Miami, Miami, FL, USADiabetes Research Institute (DRI) and Clinical Cell Transplant Program, Miller School of Medicine, University of Miami, Miami, FL, USADiabetes Research Institute (DRI) and Clinical Cell Transplant Program, Miller School of Medicine, University of Miami, Miami, FL, USADiabetes Research Institute (DRI) and Clinical Cell Transplant Program, Miller School of Medicine, University of Miami, Miami, FL, USADiabetes Research Institute (DRI) and Clinical Cell Transplant Program, Miller School of Medicine, University of Miami, Miami, FL, USADivision of Cellular Transplantation, Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USADiabetes Research Institute (DRI) and Clinical Cell Transplant Program, Miller School of Medicine, University of Miami, Miami, FL, USAIslet cell transplantation (ITx) is an effective therapeutic approach for selected patients with type 1 diabetes with hypoglycemia unawareness and severe hypoglycemia events. In organ transplantation, human leukocyte antigen (HLA) mismatching between donor and recipient negatively impacts transplant outcomes. We aimed to determine whether HLA matching has an impact on islet allograft survival. Forty-eight patients were followed up after islet transplantation at our institution from 2000 to 2020 in a retrospective cohort. Patients underwent intrahepatic ITx or laparoscopic omental approach. Immunosuppression was dependent upon the protocol. We analyzed HLA data restricted to A, B, and DR loci on allograft survival using survival and subsequent multivariable analyses. Patients were aged 42.8 ± 8.4 years, and 64.3% were female. Diabetes duration was 28.6 ± 11.6 years. Patients matching all three HLA loci presented longer graft survival ( P = 0.030). Patients with ≥1 HLA-B matching had longer graft survival compared with zero matching ( P = 0.025). The number of HLA-B matching was positively associated with time of graft survival (Spearman’s rho = 0.590; P = 0.034). Analyses adjusted for confounders showed that ≥1 matching for HLA-B decreased the risk of allograft failure ( P = 0.009). Our data suggest that HLA-B matching between recipients and donors improved islet allograft survival. Matching all three HLA loci (A, B, and DR) was also associated with prolonged islet allograft survival. Prospective studies and a larger sample size are warranted to validate our findings.https://doi.org/10.1177/09636897231166529 |
| spellingShingle | Joana R. N. Lemos David A. Baidal Raffaella Poggioli Virginia Fuenmayor Carmen Chavez Ana Alvarez Camillo Ricordi Rodolfo Alejandro HLA-B Matching Prolongs Allograft Survival in Islet Cell Transplantation Cell Transplantation |
| title | HLA-B Matching Prolongs Allograft Survival in Islet Cell Transplantation |
| title_full | HLA-B Matching Prolongs Allograft Survival in Islet Cell Transplantation |
| title_fullStr | HLA-B Matching Prolongs Allograft Survival in Islet Cell Transplantation |
| title_full_unstemmed | HLA-B Matching Prolongs Allograft Survival in Islet Cell Transplantation |
| title_short | HLA-B Matching Prolongs Allograft Survival in Islet Cell Transplantation |
| title_sort | hla b matching prolongs allograft survival in islet cell transplantation |
| url | https://doi.org/10.1177/09636897231166529 |
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