Evidence of recurrent autoimmunity in human allogeneic islet transplantation

Transplantation. 1996 Apr 27;61(8):1272-4. doi: 10.1097/00007890-199604270-00027.

Abstract

We transplanted 10,000 isolated, handpicked human pancreatic islets into the subfascial compartment of the forearm muscle of a type I diabetic recipient who had received a successful renal transplant one year prior. The recipient was maintained on his usual immunosuppressive therapy of cyclosporine, azathioprine, and prednisone. A biopsy performed 7 days after transplantation showed normal islets with both insulin- and glucagon-staining cells present and no lymphocytic infiltration. A second biopsy performed 14 days after transplantation showed a dense mononuclear cell infiltrate with a preferential loss of insulin-staining cells relative to glucagon-staining cells in the islets. These data are consistent with recurrent autoimmune diabetes in an isolated islet allograft in an immunosuppressed type I diabetic recipient. In addition, this forearm subfascial site may be a useful means to monitor islet rejection and autoimmune recurrence in therapeutic intraportal islet allografts.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 1 / therapy
  • Forearm
  • Glucagon / analysis
  • Humans
  • Immunohistochemistry
  • Insulin / analysis
  • Islets of Langerhans / metabolism
  • Islets of Langerhans / pathology
  • Islets of Langerhans Transplantation*
  • Male
  • Recurrence
  • Transplantation, Homologous

Substances

  • Insulin
  • Glucagon