Graft failure after allogeneic islet transplantation in a patient with type 1 diabetes and a high anti-glutamic acid decarboxylase antibody titer

J Diabetes Investig. 2023 May;14(5):725-729. doi: 10.1111/jdi.13996. Epub 2023 Mar 1.

Abstract

Pancreatic islet transplantation is a β-cell replacement therapy for people with insulin-deficient diabetes who have difficulty in glycemic control and suffer from frequent severe hypoglycemia. However, the number of islet transplantations carried out is still limited in Asia. We report a case of allogeneic islet transplantation in a 45-year-old Japanese man with type 1 diabetes. Although the islet transplantation was successfully carried out, graft loss was observed on the 18th day. Immunosuppressants were used in accordance with the protocol, and donor-specific anti-human leukocyte antigen antibodies were not detected. Autoimmunity relapse was also not observed. However, the patient had a high titer of anti-glutamic acid decarboxylase antibody from before the islet transplantation, and autoimmunity might thus have affected the β-cells in the transplanted islet. The evidence is still scarce to reach conclusions, and further data accumulation is required to enable proper patient selection before islet transplantation.

Keywords: Autoimmunity; Islet transplantation; Type 1 diabetes mellitus.

Publication types

  • Case Reports

MeSH terms

  • Antibodies
  • Diabetes Mellitus, Type 1* / surgery
  • Glutamate Decarboxylase
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Islets of Langerhans Transplantation* / methods
  • Male
  • Middle Aged

Substances

  • Glutamate Decarboxylase
  • Antibodies