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Pancreas 1

Monday September 12, 2022 - 16:25 to 17:25

Room: C5

234.7 Prevalence of type 1 diabetes auto-antibodies in a large cohort of pancreas allograft recipients

Diego Cantarovich, France

Nephrology and Immunology Clinic
Centre Hospitalier Universitaire de Nantes


Dr. Diego Cantarovich was born in Buenos Aires (Argentina). He graduated in Medicine from the University of Buenos Aires and completed his fellowship in Nephrology at the University Hospital Edouard Herriot, Lyon, France. Dr. Cantarovich is Professor of Medical Sciences, Université Claude Bernard, Lyon. He completed a PhD in Immunology in Nantes with main interest on islet xenotransplantation. He is a University Hospital Practioner at the Transplantation Institute in Nantes since 1986 were he founded the pancreas and the islet transplant programs. He is a founder member of IPITA and Chairman of the European Pancreas and Islet Transplant Registry since 2020. His main clinical research focuses on pancreas and islet transplantation, and immunosuppression strategies and steroid avoidance in kidney and pancreas/kidney transplantation.


Prevalence of type 1 diabetes auto-antibodies in a large cohort of pancreas allograft recipients

Delphine Kervella1, Kalyane Bach3, Marine Ollivier2, Lucy Chaillous2, Julien Branchereau1, Georges Karam1, Diego Cantarovich1.

1Institute of Transplantation-Urology-Nephrology, Nantes University Hospital, Nantes, France; 2Institut du Thorax, Endocrinology Unit, Nantes University Hospital, Nantes, France; 3Biochemical Laboratory, Nantes University Hospital, Nantes, France

Introduction: Type 1 diabetes auto-antibodies seem to be associated to type 1 diabetes recurrence on the pancreas allograft. The aim of this study was to describe the prevalence of type 1 diabetes auto-antibodies and type 1 diabetes recurrence in a cohort of pancreas allograft recipients.

Methods: Between 2017 and 2019, all pancreas allograft recipients (simultaneous pancreas and kidney, pancreas transplant alone or pancreas after kidney) were screened annually for type 1 diabetes auto-antibodies (anti-IA2, anti-ZnT8 and anti-GAD65). Type 1 diabetes recurrence was defined by the following criteria: hyperglycaemia requiring insulin therapy; a severe loss of C-peptide; seroconversion of type 1 diabetes autoantibodies; the presence of insulitis on pancreas transplant biopsy; and the absence of pancreatic rejection.

Results: 244 patients who received a pancreas allograft before 2017 were included. 108 patients (44%) had anti-GAD65 antibodies, 50 (20%) anti-ZnT8 antibodies et 45 (18%) anti-IA2 antibodies. All three antibodies were positive in 11 patients (5%). Type 1 diabetes recurrence occurred in one patient at 6 years posttransplant and was suspected for seven patients in association to rejection of the pancreas allograft. Between 2017 and 2019, 51 patients received a pancreas allograft. Before transplantation, 23 of those (45%) had anti-GAD65 antibodies, 4 (8%) anti-ZnT8 antibodies and 5 (10%) anti-IA2 antibodies. Only one patient had three positive auto-antibodies. With a follow-up of 0 to 2 years, none of these newly transplanted patients had 3 positive auto-antibodies. No case of recurrence occurred in these patients.

Conclusion: We describe a very high prevalence of type 1 diabetes auto-antibodies after pancreas transplantation, but graft loss due to type 1 diabetes recurrence appears to be a rare event.

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