Baseline Immune Assessment to Individualize Immunosuppression in SPK Recipients with Type 1 Diabetes.
Mayo Clinic, Rochester, MN
Meeting: 2017 American Transplant Congress
Abstract number: 175
Keywords: Immunosuppression, Pancreas transplantation, T cells
Session Information
Session Name: Concurrent Session: Pancreas Transplantation
Session Type: Concurrent Session
Date: Sunday, April 30, 2017
Session Time: 4:30pm-6:00pm
Presentation Time: 4:54pm-5:06pm
Location: E267
Introduction:Type 1 diabetes (T1D) is an immune-mediated disorder associated with multiple immunological anomalies. Immunologic abnormalities might help to explain why recipients of simultaneous pancreas kidney (SPK) transplantation develop a higher rate of infection and/or rejection after transplantation. The goal was to compare pretransplant immunophenotypes of patients with T1D waitlisted for SPK to controls and non T1D waitlisted for kidney transplantation
Methods: We perfomed immunophenotyping by flow cytometry investigating the T, B, NK cell and immunoglobulin (Ig) levels on 48 subejcts.; 1) 20 patients wait-listed for SPK 2) 19 controls 3) 9 patients wait-listed for kidney transplantation (non T1D ESRD)
Results: We studied 48 patients comparable for age and gender (46.5±10.09 years and M/F 26/22). T and B cells were similar in all 3 groups, NK cells and IgG were lower in SPK group comapred to non T1D ESRD and controls (Table 1). Similary, in subgroup analysis, we observed NK cell lymphopenia in the SPK group compared to controls (P=0.0050);IgG levels were lower in the SPK group compared to non-T1D ESRD (p=0.00149).
Conclusion: SPK patients show evidence of NK cell lymphopenia and hypogammaglobulinemia compared to controls or non-T1D ESRD respectively prior to transplant suggesting intrinsic defects that may contribute to disease pathogenesis. Further studies are required to determine the impact of these findings on outcome post-transplant.
| Lymphocyte subsets | SPK(n=20) | Non T1D ESRD (n=8) | Controls(n=19) | P value |
| Absolute count (cells/[micro]L) | Absolute count (cells/[micro]L) | Absolute count (cells/[micro]L) | ||
| CD45+ (thou/uL) | 1.5±0.5 | 1.68±0.6 | 2±0.5 | 0.26 |
| CD 19+ | 150±88 (10%) | 159±128 (9%) | 212±156 (11.5%) | 0.29 |
| CD3+ | 1203±553 (78%) | 1258±485 (76%) | 1323±367 (73.4%) | 0.69 |
| CD4+ | 770±372 (52%) | 908±278 (56%) | 826±274 (46%) | 0.56 |
| CD8+ | 398±226 (25%) | 339±236 (19%) | 476±184 (23%) | 0.25 |
| CD4:CD8 | 2.4±2 | 3.4±2 | 2±2 | 0.09 |
| NK cells (CD 16+CD56+) | 146±39 (10%) | 212.6±119 (13.3%) | 243±114 (13.4%) | 0.0064 |
| IgA (mg/dL) | 203±116 | 230±165 | 215±82 | 0.58 |
| IgG | 1106±196 | 1371±458 | 1099±165 | 0.0203 |
| IgM | 110±66 | 92±43 | 114±57 | 0.71 |
CITATION INFORMATION: Kudva Y, Dadlani V, Miller A, Abdallah M, Kremers W, Stegall M, Abraham R. Baseline Immune Assessment to Individualize Immunosuppression in SPK Recipients with Type 1 Diabetes. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Kudva Y, Dadlani V, Miller A, Abdallah M, Kremers W, Stegall M, Abraham R. Baseline Immune Assessment to Individualize Immunosuppression in SPK Recipients with Type 1 Diabetes. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/baseline-immune-assessment-to-individualize-immunosuppression-in-spk-recipients-with-type-1-diabetes/. Accessed November 21, 2024.« Back to 2017 American Transplant Congress