RITRAPIANTO DI PANCREAS DOPO RICORRENZA DI DIABETE MELLITO (DM) AUTOIMMUNE NEL PANCREAS TRAPIANTATO

Research output: Other contribution

Abstract

[automatically translated] Introduction: Pancreas transplantation is an effective treatment for the cure of diabetes mellitus (DM) type 1. However, some patients develop anti-islet antibodies after transplantation which are capable of destroying the endocrine pancreas and culminate in DM recurring difficult to manage . Materials and Methods: A retrospective study was performed on patients who received re-pancreas transplantation for graft failure after combined kidney-pancreas transplant (SPK) between 1990 and 2008 at our center. They were analyzed clinical data, laboratory, histopathological obtained by immunological studies. Results: a total of 16 re-pancreas transplants, 3 cases (one man and two women) received pancreas retransplantation for recurrent autoimmune diabetes. The immunosuppressive induction therapy provided Thymoglobulin and daclizumab in all cases, while maintaining provided with tacrolimus or sirolimus, mycophenolate and low-dose steroids. All patients admitted from the first transplant had an uncomplicated course. However all of them developed auto-antibodies and in some cases developed DM type 1 to 2, 3 and 5 years after SPK. Among all cases of re-transplantation, 2 of them still have a normal pancreatic function, however, a case developed auto-antibodies and autoreactive T lymphocytes after re-transplantation and of his pancreas he became insufficient two years after the second transplantation. Conclusion: The transplanted pancreas can be destroyed by the reappearance of anti-islet antibodies and may culminate in DM that can be treated safely with re-pancreas transplant.
Original languageItalian
Publication statusPublished - 2009

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